Individual
DR. AMY DE LONG
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD MPH
Contact information
Practice address
S2845 WHITE EAGLE LANE, BARABOO, WI 53913
(608) 355-1240
(608) 356-6347
Mailing address
S2845 WHITE EAGLE LANE, BARABOO, WI 53913
(608) 355-1240
(608) 356-6347
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
44246
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0012
WPS STATE PART B
WI
05
—
34508300
—
WI
Enumeration date
11/06/2006
Last updated
02/01/2022
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