Individual
JAMES P LONG
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
675 W WASHINGTON AVE, MADISON, WI 53703-2637
(608) 257-9700
Mailing address
675 W WASHINGTON AVE, MADISON, WI 53703-2637
(608) 257-9700
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
23658020
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
30460300
—
WI
Enumeration date
08/04/2006
Last updated
07/08/2007
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