Individual
WALLACE A LONGTON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
25 SPRINT DR, CARLISLE, PA 17015
(717) 960-3726
(717) 960-3734
Mailing address
409 S 2ND ST STE 2F, HARRISBURG, PA 17104-1612
(717) 231-8937
(717) 231-8588
Taxonomy
Speciality
Code
Description
License number
State
2085R0001X
Radiation Oncology Physician
Primary
MD061183L
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
001774731
—
PA
Enumeration date
06/03/2006
Last updated
10/11/2017
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