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Individual

DR. JOHN R LONG

Active
Sole proprietor

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
5819 OLD HARDING RD, NASHVILLE, TN 37205-3619
(615) 352-2990
(615) 352-9085
Mailing address
1507 CEDAR LN, NASHVILLE, TN 37212-5913

Taxonomy

Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
39529
TN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
5440545
TN
Enumeration date
03/28/2006
Last updated
07/08/2007
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