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Individual

WILLIAM BROUGHTON LONG III

Active
Sole proprietor

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
501 N GRAHAM, SUITE # 580, PORTLAND, OR 97227
(503) 528-0704
(503) 528-0708
Mailing address
501 N GRAHAM, SUITE # 580, PORTLAND, OR 97227
(503) 528-0704
(503) 528-0708

Taxonomy

Speciality
Code
Description
License number
State
2086S0127X
Trauma Surgery Physician
MD00023470
WA
2086S0127X
Trauma Surgery Physician
Primary
MD13786
OR

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
290536
OR
Enumeration date
01/24/2006
Last updated
07/08/2007
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