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Individual

THOMAS WILLIAM LONGLEY

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
4208 CENTRAL AVE SW, ALBUQUERQUE, NM 87105-1695
(505) 777-3001
(505) 808-4977
Mailing address
PO BOX 740018, ATLANTA, GA 30374-0018
(505) 777-3001
(505) 808-4977

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
MD2014-0860
NM
390200000X
Student in an Organized Health Care Education/Training Program

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
31459820
NM
Enumeration date
04/19/2012
Last updated
03/12/2026
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