Long, Douglas M.

Long, Douglas M. is an individual health care provider with primary practice located at N19W23993 Ridgeview Pkwy W Ste 100 , Waukesha WI 53188-1031. He recently has only one registered license in Allopathic & Osteopathic Physicians / Ophthalmology, which is considered as his primary health care specialty. Long, Douglas M. can be contacted via phone (262) 547-3352.

Contact Information

Primary practice address
N19W23993 Ridgeview Pkwy W Ste 100 Waukesha WI 53188-1031
Phone: (262) 547-3352
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Ophthalmology 207W00000X 39703 Wisconsin

Profile Details

NPI number 1255368528
LBN Legal business name Long, Douglas M.
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 26th, 2006
Last updated Dec 26th, 2023 - about 2 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1255368528 NPPES
Wisconsin Other P00449642 RR MEDICARE
Wisconsin MEDICAID 32443200 RR MEDICARE

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