Individual
DR. JOHN JACOB LONG
Active
Individual
DR. JOHN JACOB LONG
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
2004020474
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
209326909
—
MO
Enumeration date
07/03/2006
Last updated
04/17/2025
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