Individual
LONG DO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
501 S CALHOUN ST, TALLAHASSEE, FL 32399-6548
(850) 717-3269
(850) 921-9757
Mailing address
501 S CALHOUN ST, TALLAHASSEE, FL 32399-6548
(850) 717-3269
(850) 921-9757
Taxonomy
Speciality
Code
Description
License number
State
208D00000X
General Practice Physician
Primary
ME47732
FL
Other
Enumeration date
07/22/2014
Last updated
07/22/2014
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