Individual
MS. JO ANN LONGENECKER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
2673 DAVISSON RUN RD STE 101, CLARKSBURG, WV 26301-6838
(681) 342-3470
(304) 622-6109
Mailing address
2324 HAWK HIGHWAY, LOST CREEK, WV 26385-9707
(304) 745-3200
(304) 745-4068
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
15551
WV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0041652000
—
WV
Enumeration date
10/12/2006
Last updated
04/06/2022
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