Organization
STEPHENIE R. LONG, MD LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. STEPHENIE R. LONG M.D. (OWNER)
(318) 281-0065
Entity
Organization
Contact information
Practice address
420 S VINE ST, BASTROP, LA 71220-4514
(318) 281-0065
(318) 281-0052
Mailing address
420 S VINE ST, BASTROP, LA 71220-4514
(318) 281-0065
(318) 281-0052
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
022299
LA
Other
Enumeration date
08/18/2006
Last updated
08/22/2020
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