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Individual

HERBERT W LONG

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
417 RIVER DR, IRVINE, KY 40336-1272
(606) 723-0399
(606) 723-0379
Mailing address
PO BOX 936, LONDON, KY 40743-0936
(606) 330-7818
(606) 330-7825

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
31482
KY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
000000052184
ANTHEM BCBS ID
KY
01
000889063
HUMANA
KY
01
01-00767
UNITED HEATLH CARE
KY
01
1166070
CHA HEALTH
KY
01
1532269
UMWA
KY
01
2768
BLUEGRASS FAMILY HEALTH
KY
05
35001262
KY
01
5211107
AETNA ID
KY
01
61-1341297
TRICARE
KY
05
64314826
KY
Enumeration date
06/09/2005
Last updated
08/07/2019
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