Individual
DR. GEORGE MADISON LONG JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DPM
Contact information
Practice address
2401 GODWIN BLVD, STE 1, SUFFOLK, VA 23434-8178
(757) 539-2098
(757) 539-5188
Mailing address
2401 GODWIN BLVD, STE 1, SUFFOLK, VA 23434-8178
(757) 539-2098
(757) 539-5188
Taxonomy
Speciality
Code
Description
License number
State
213E00000X
Podiatrist
Primary
0103000593
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
009301879
—
VA
Enumeration date
08/23/2005
Last updated
11/20/2007
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