Individual
DR. RICHARD L. LONG
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
201 ST. ANN DRIVE, SUITE B, MANDEVILLE, LA 70471
(985) 626-1717
(985) 674-2814
Mailing address
201 ST. ANN DRIVE, SUITE B, MANDEVILLE, LA 70471
(985) 626-1717
(985) 674-2814
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
000041
LA
207Q00000X
Family Medicine Physician
10861
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1459992
—
LA
Enumeration date
06/16/2006
Last updated
07/31/2012
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