Individual
THOMAS N LONG
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1001 W EAGLE DR, DECATUR, TX 76234-3745
(940) 627-7443
(940) 627-7464
Mailing address
1001 W EAGLE DR, DECATUR, TX 76234-3745
(940) 627-7443
(940) 627-7464
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
F0565
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
020030286
RAILROAD MEDICARE
TX
05
—
177596001
—
TX
Enumeration date
08/25/2006
Last updated
08/31/2010
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