Individual
DR. TERESA DIANE LONG
Active
Individual
DR. TERESA DIANE LONG
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
04-25118
KS
2084P0800X
Psychiatry Physician
04-25118
KS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
20924044
BCBS KC
MO
01
—
626411
FIRSTGUARD
KS
Enumeration date
10/03/2006
Last updated
09/11/2025
Update your record
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