Individual
RAYMOND A LONG
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1397 BROAD AVE, GULFPORT, MS 39501-2419
(228) 867-5012
Mailing address
217 SAINT JOSEPH ST, WAVELAND, MS 39576-4109
(518) 570-5910
(228) 575-1964
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
MC-126
GU
207XX0801X
Orthopaedic Trauma Physician
29746
MS
207XX0801X
Orthopaedic Trauma Physician
75914
GA
207XX0801X
Orthopaedic Trauma Physician
Primary
ME80065
FL
207XX0801X
Orthopaedic Trauma Physician
MMD.94003.MD
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
14J8Y
BC/BS
FL
05
—
PENDING
—
FL
Enumeration date
10/14/2010
Last updated
04/29/2025
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