Individual
JAMES H LONG JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1530 LONE OAK RD, PADUCAH, KY 42003-7901
(270) 415-3650
(270) 415-3608
Mailing address
2200 JEFFERSON AVE FL 5, TOLEDO, OH 43604-7102
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
25388
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
64253883
—
KY
01
—
K232360
MEDICARE PTAN
KY
Enumeration date
11/08/2006
Last updated
03/01/2019
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