Individual
STEPHEN LAYNE LONG
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
437 DENISON ST, CONWAY, AR 72034-6127
(501) 327-1325
(501) 327-1328
Mailing address
PO BOX 10553, CONWAY, AR 72034-0009
(501) 327-1325
Taxonomy
Speciality
Code
Description
License number
State
2083X0100X
Occupational Medicine Physician
C5423
AR
208D00000X
General Practice Physician
Primary
C5423
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
101307001
—
AR
Enumeration date
07/27/2006
Last updated
12/03/2012
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