Organization
MARY INGRAM LONG A PROFESSIONAL MEDICAL CORPORATION
Active
Other names
Mary I Long
Organization subpart
No
Provider details
NPI number
Authorized official
MARY LONG MD (OWNER / PROVIDER)
(318) 354-9348
Entity
Organization
Contact information
Practice address
114 E 5TH ST, NATCHITOCHES, LA 71457-5725
(318) 354-9348
(318) 354-9269
Mailing address
114 E 5TH ST, NATCHITOCHES, LA 71457-5725
(318) 354-9348
(318) 354-9269
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
MD 022285
LA
Other
Enumeration date
04/12/2010
Last updated
04/12/2010
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