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Individual

DR. JAIME B LONG

Active
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Individual

DR. JAIME B LONG

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
M.D.

Taxonomy

Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
MD433918
PA
207VF0040X
Urogynecology and Reconstructive Pelvic Surgery (Obstetrics & Gynecology) Physician
Primary
MD433918
PA
207VX0201X
Gynecologic Oncology Physician
34110
AZ

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
010213023
PA
01
127992
MEDICARE
PA
01
86080015085259C450
TRIWEST
AZ
05
939754
AZ
01
P00272876
RAILROAD MEDICARE
AZ
01
P00670380
RAILROAD MEDICARE - READING PROFESSIONAL SERVICES
PA
Enumeration date
12/09/2005
Last updated
01/11/2019
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