Individual
DR. CHARLES A LONGDON
Active
Individual
DR. CHARLES A LONGDON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.O.
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
036109417
IL
207P00000X
Emergency Medicine Physician
44365-021
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
43498200
—
WI
01
—
930121753
MEDICARE RAILROAD
WI
01
—
930123615
MEDICARE RAILROAD
WI
01
—
P00153529
MEDICARE RAILROAD
WI
Enumeration date
06/30/2006
Last updated
01/12/2023
Update your record
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