Individual
DR. WILLIAM JEFFREY LONG
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1051 GAUSE BLVD, STE 320, SLIDELL, LA 70458-2988
(985) 726-2655
(985) 643-9808
Mailing address
1051 GAUSE BLVD, STE 320, SLIDELL, LA 70458-2988
(985) 726-2655
(985) 643-9808
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
Primary
017055
LA
207RC0000X
Cardiovascular Disease Physician
7248
NH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
09013682
—
MS
05
—
1389480
—
LA
Enumeration date
05/31/2005
Last updated
03/24/2010
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