Individual
BENJAMIN LONG
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
520 E 6TH ST, ODESSA, TX 79761-4527
(432) 582-8000
Mailing address
1301 CONCORD TER, SUNRISE, FL 33323-2843
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
V9055
TX
2080S0012X
Pediatric Sleep Medicine Physician
31403
NE
Other
Enumeration date
08/19/2013
Last updated
08/12/2025
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