Individual
DR. GEORGANNE LONG
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
1401 JOHNSTON WILLIS DR, SUITE 5000, RICHMOND, VA 23235-4730
(804) 320-2483
(804) 794-0050
Mailing address
1 PARKWEST CIR, SUITE 202, MIDLOTHIAN, VA 23114-5551
(804) 320-2483
(804) 794-0050
Taxonomy
Speciality
Code
Description
License number
State
207VG0400X
Gynecology Physician
Primary
0101042241
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0000083419002
UNITED
—
01
—
0862248
AETNAUSHEALTH
—
01
—
10240697
VA PREMIER
—
01
—
11941
CARENET
—
01
—
226117
ANTHEM
—
01
—
2640631
CIGNA
—
01
—
328078
MAMSI
—
01
—
51812
SENTARA
—
01
—
541941044002
TRICARE
—
01
—
94537
SOUTHERN HEALTH
—
Enumeration date
01/17/2006
Last updated
02/15/2008
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