Mary Ingram Long A Professional Medical Corporation
Internal Medicine in Natchitoches, LA. Organization (NPI-2).
NPI number1932425337
StatusActive
Last updated in NPPESApr 12, 2010
Details
- NPI
- 1932425337
- Entity type
- Organization (NPI-2)
- Legal business name
- Mary Ingram Long A Professional Medical Corporation
- Organization subpart
- No
- Enumeration date
- Apr 12, 2010
- Last updated
- Apr 12, 2010
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 207R00000X | Internal Medicine | MD 022285 | LA | Yes |
Other names
- Mary I Long (Doing Business As)
Practice location
114 E 5th StNatchitoches, LA 71457-5725
Phone 318-354-9348 · Fax 318-354-9269
Mailing address
114 E 5th StNatchitoches, LA 71457-5725
Phone 318-354-9348 · Fax 318-354-9269
Authorized official
Mary Long
Owner / Provider
3183549348
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