Individual
MR. JOHN A LONG JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
10810 CONNECTICUT AVE, KAISER PERMANENTE KENSINGTON MEDICAL CENTER, KENSINGTON, MD 20895-2138
(301) 929-7100
Mailing address
2101 E JEFFERSON ST, KAISER PERMANENTE MEDICARE ENROLLMENT, ROCKVILLE, MD 20852-4908
(301) 816-2424
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
0101031814
VA
2085R0202X
Diagnostic Radiology Physician
Primary
D22299
MD
2085R0202X
Diagnostic Radiology Physician
MD33242
DC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
7200617
—
VA
Enumeration date
02/15/2006
Last updated
12/06/2012
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