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Individual

WILLIAM F LONG

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
1315 HOSPITAL DR, ST JOHNSBURY, VT 05819-9210
(802) 748-8141
Mailing address
1315 HOSPITAL DR, PO BOX 905, ST JOHNSBURY, VT 05819-9210
(802) 748-8141

Taxonomy

Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
068-0045710
VT
208D00000X
General Practice Physician
Primary
042-0009733
VT

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
0VN1814
VT
05
3076026
NH
Enumeration date
08/11/2006
Last updated
04/05/2016
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