Individual
STEPHANIE C LONG
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
513 BURKARTH RD, WARRENSBURG, MO 64093-3103
(660) 747-7751
Mailing address
513 BURKARTH RD, WARRENSBURG, MO 64093-3103
(660) 747-7751
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
104166
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
19595012
BCBS
MO
05
—
206687006
—
MO
Enumeration date
06/08/2006
Last updated
11/09/2016
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