Individual
DR. PAUL R. LONG
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1155 E MOUNTAIN BLVD, WILKES BARRE, PA 18702-7906
(570) 820-6113
(570) 808-6349
Mailing address
100 N ACADEMY AVE, DANVILLE, PA 17822-3034
(570) 271-6144
(570) 271-6578
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
MD019504E
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000737850
—
PA
Enumeration date
03/31/2006
Last updated
03/11/2025
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