Long, Justin M

Long, Justin M is an individual health care provider with primary practice located at 4921 Parkview Pl Div Neurology Aging And Dementia, Ste 6C, Saint Louis MO 63110-1032. He recently has only one registered license in Allopathic & Osteopathic Physicians / Neurology, which is considered as his primary health care specialty. Long, Justin M can be contacted via phone (314) 362-1408.

Contact Information

Primary practice address
4921 Parkview Pl Div Neurology Aging And Dementia, Ste 6C Saint Louis MO 63110-1032
Phone: (314) 362-1408
Fax: (314) 286-1985
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Neurology 2084N0400X 2017016924 Missouri

Profile Details

NPI number 1053725531
LBN Legal business name Long, Justin M
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 12th, 2014
Last updated Apr 25th, 2024 - about last year

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 1053725531 NPPES
Missouri MEDICAID 200055731

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