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WARREN DAVID. LONG NPI 1689834400


NPI Information

NPI: 1689834400
Provider Name: WARREN DAVID. LONG
Classification: Specialist - 174400000X
Entity Type: Organization
Address:
2625 LINE AVE
155
SHREVEPORT, LA
ZIP 71104
Phone: (318) 424-8436
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WARREN DAVID. LONG is a specialist in Shreveport, LA. The provider is an individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree. WARREN DAVID. LONG NPI is 1689834400. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

2625 LINE AVE
155
SHREVEPORT, LA
ZIP 71104-047
Phone: (318) 424-8436
Fax: (318) 424-8438

The provider's authorized official is Warren David Long .
The authorized official title is Md/owner and has the following contact phone number (318) 424-8436.

The enumeration date for this NPI number is 6/16/2008 and was last updated on 6/16/2008.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1174400000XSpecialist02812RLOUISIANAYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
1B60836MEDICARE UPINLOUISIANA
21107948MEDICAIDLOUISIANA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

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