Individual
LONG PHAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
1125 HIGHWAY US-79 S, HAUGHTON, LA 71037
(318) 949-8476
Mailing address
801 WARHAWK WAY APT 20, MONROE, LA 71203-3162
(318) 654-4047
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
PMP.036194-PST
LA
Other
Enumeration date
12/01/2025
Last updated
12/01/2025
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