Individual
DR. JEFFREY P. LONG
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
8166 MAIN ST, STE 101, HOUMA, LA 70360-3404
(985) 876-9045
Mailing address
4950 ESSEN LN, BATON ROUGE, LA 70809-3738
(225) 215-1311
Taxonomy
Speciality
Code
Description
License number
State
2085R0001X
Radiation Oncology Physician
MD00038248
WA
2085R0203X
Therapeutic Radiology Physician
Primary
202753
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1450243
—
LA
Enumeration date
09/22/2006
Last updated
12/28/2011
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