Individual
DR. WILLIAM LAWRENCE LONG
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
100 MEDICAL CENTER DRIVE, PRINCETON, KY 42445-0410
(270) 365-0442
(270) 365-6528
Mailing address
PO BOX 42, HOPKINSVILLE, KY 42441-0042
(270) 886-4556
(270) 707-9650
Taxonomy
Speciality
Code
Description
License number
State
2085U0001X
Diagnostic Ultrasound Physician
Primary
18271
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000185273
BLUE CROSS/BLUE SHIELD
KY
01
—
1786607
ACR MEMBERSHIP #
—
01
—
18271
MEDICAL LICENSE
KY
01
—
300117516
RAILROAD MEDICARE
—
05
—
64182710
—
KY
01
—
M05431
MEDICAL LICENSE
TN
05
—
P 64182710
—
KY
Enumeration date
03/24/2006
Last updated
02/18/2015
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