Individual
ROBERT THEODORE LONGSHORE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
870 US HWY 42 W, WARSAW, KY 41095-9323
(859) 567-1591
(859) 567-1592
Mailing address
2546 KEARNEY COURT, LAKESIDE PARK, KY 41017-2180
(859) 344-8116
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
12488
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
64124886
—
KY
Enumeration date
07/25/2006
Last updated
07/08/2007
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