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Individual

DR. JOHN MACLOU LONGO

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
9200 W WISCONSIN AVE, RADIATION ONCOLOGY, MILWAUKEE, WI 53226-3522
(414) 805-4400
(414) 805-4369
Mailing address
9200 W WISCONSIN AVE, RADIATION ONCOLOGY, MILWAUKEE, WI 53226-3522
(414) 805-4400
(414) 805-4369

Taxonomy

Speciality
Code
Description
License number
State
2085R0001X
Radiation Oncology Physician
Primary
57527
WI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1356631139
WI
Enumeration date
04/13/2011
Last updated
04/07/2023
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