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Individual

CHARLES E LONGMOOR

Active
Sole proprietor

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
1100 KENTUCKY AVENUE, WEST PLAINS, MO 65775
(417) 256-9111
(417) 257-5838
Mailing address
152 LEMAY FERRY RD, SUITE 201, SAINT LOUIS, MO 63125-1253
(800) 354-1088
(314) 631-4491

Taxonomy

Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
105540
MO

Other

Enumeration date
06/07/2006
Last updated
07/09/2007
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