Individual
KEITH C LONG
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D
Contact information
Practice address
13737 SPOTSWOOD TRL, ELKTON, VA 22827-3200
(540) 713-4100
(844) 305-8671
Mailing address
PO BOX 1430, HARRISONBURG, VA 22803-1430
(540) 713-4100
(844) 305-8671
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
0101054658
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1417933870
—
VA
Enumeration date
12/19/2005
Last updated
07/03/2019
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