Individual
DOUGLAS G LONG
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
3801 E HIGHWAY 98, ER, PORT ST JOE, FL 32456-5318
(850) 229-5600
(850) 475-4781
Mailing address
PO BOX 2699, PENSACOLA, FL 32513-2699
(850) 229-5600
(850) 475-4781
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
3908
AK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
MD39082
—
AK
Enumeration date
09/05/2006
Last updated
02/26/2014
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