Individual
KEVIN CARL LONG
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
100 NORTH ACADEMY AVE, MC 21-69, DANVILLE, PA 17822
(570) 271-6361
(570) 271-8324
Mailing address
100 N ACADEMY AVE, DANVILLE, PA 17822-4903
(570) 271-6144
(570) 271-6578
Taxonomy
Speciality
Code
Description
License number
State
208C00000X
Colon & Rectal Surgery Physician
Primary
MD455224
PA
Other
Enumeration date
06/15/2009
Last updated
08/31/2020
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