Individual
ELWOOD N LONGENECKER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
2000 SOUTH 900 EAST, SALT LAKE CITY, UT 84105
(801) 464-7777
Mailing address
PO BOX 27128, SALT LAKE CITY, UT 84127-0128
(801) 233-4400
(801) 233-4410
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
30831491205
UT
Other
Enumeration date
09/19/2006
Last updated
10/20/2007
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