Individual
DR. JOHN CHARLES LONG JR.
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
155 N NOVA RD, ORMOND BEACH, FL 32174-5138
(386) 672-3111
(386) 672-6532
Mailing address
155 N NOVA RD, ORMOND BEACH, FL 32174-5138
(386) 672-3111
(386) 672-6532
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
ME0068137
FL
Other
Enumeration date
08/08/2006
Last updated
07/08/2007
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