Individual
JOHN M LONGO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
311 S CLARK ST, CARROLL, IA 51401-3038
(712) 792-8265
(712) 792-8264
Mailing address
657 N 57TH AVE, OMAHA, NE 68132-2037
(402) 556-4617
Taxonomy
Speciality
Code
Description
License number
State
2085R0001X
Radiation Oncology Physician
Primary
30135
IA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0177261
—
IA
Enumeration date
09/19/2005
Last updated
10/02/2008
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