Individual
DR. JOHN D LONG JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
14139 POTOMAC MILLS RD, KAISER PERMANENTE WOODBRIDGE MEDICAL CENTER, WOODBRIDGE, VA 22192-4644
(703) 490-8400
(703) 490-7635
Mailing address
2101 E JEFFERSON ST, KAISER PERMANENTE MEDICARE ENROLLMENT, ROCKVILLE, MD 20852-4908
(301) 816-2424
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
0101043730
VA
Other
Enumeration date
12/02/2006
Last updated
11/09/2011
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