Individual
DR. KYLE Y LONG
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
725 HIGHLAND AVE, WINSTON SALEM, NC 27101-4206
(336) 607-8523
(336) 748-5438
Mailing address
1305 S CANNON BLVD, KANNAPOLIS, NC 28083-6232
(704) 939-1100
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
200400373
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
89137NW
—
NC
Enumeration date
06/03/2006
Last updated
11/13/2020
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