Individual
CLINTON ARVIN LONG
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
K5338
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
142713002
—
TX
01
—
180045779
RAILROAD MEDICARE
TX
01
—
7057235
AETNA
TX
01
—
8G9440
BCBS OF TEXAS
TX
Enumeration date
12/08/2006
Last updated
04/24/2012
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