Dr. Jack Wiley Delong, M.D.
Otolaryngology in Sarasota, FL. Individual provider (NPI-1).
NPI number1356349039
StatusActive
Last updated in NPPESAug 14, 2019
Details
- NPI
- 1356349039
- Entity type
- Individual (NPI-1)
- Name
- Dr. Jack Wiley Delong
- Credential
- M.D.
- Sex
- Male
- Sole proprietor
- No
- Enumeration date
- Jul 7, 2005
- Last updated
- Aug 14, 2019
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 207Y00000X | Otolaryngology | 4301029955 | MI | Yes |
Practice location
1900 Brother Geenen WaySarasota, FL 34236-7102
Phone 941-556-3220 · Fax 941-955-8214
Mailing address
111 W 24th StHolland, MI 49423-4791
Phone 616-396-2325 · Fax 616-396-0317
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