Individual
DR. JAMES LONG
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PH.D.
Contact information
Practice address
1100 N COLLEGE AVE, FAYETTEVILLE, AR 72703-1944
(615) 355-3451
Mailing address
PO BOX 2429, SMYRNA, TN 37167-1719
(615) 355-3451
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
05-18P
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1932174836
CLINIC NPI#
AR
01
—
5Y410
LOCAL BCBS
AR
Enumeration date
08/30/2005
Last updated
09/20/2018
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