Individual
DR. MACK H LONGMIRE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
22890 VIRGIL GOODE HWY, BOONES MILL, VA 24065
(540) 334-5511
(540) 334-3174
Mailing address
219 BARFOOT WEST RD, ROCKY MOUNT, VA 24151-5322
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
0101-221204
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
010142083
—
VA
Enumeration date
01/27/2006
Last updated
11/09/2008
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