Individual
DR. MARY INGRAM LONG
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
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
022285
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1494666
—
LA
Enumeration date
07/01/2005
Last updated
03/03/2009
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