Individual
CORY R. LONG
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1000 E MAIN ST, DANVILLE, IN 46122-1948
(317) 745-4451
(317) 718-6740
Mailing address
1000 E MAIN ST, DANVILLE, IN 46122-1948
(317) 745-4451
(317) 718-6740
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
01069779A
IN
207P00000X
Emergency Medicine Physician
097150
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000823438
ANTHEM PIN
IN
05
—
0076978
—
OH
05
—
201153410
—
IN
Enumeration date
08/12/2009
Last updated
03/29/2021
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