Long, Michael David

Long, Michael David is an individual health care provider with primary practice located at 6012 82Nd St Ste 15 , Lubbock TX 79424-3671. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / MOHS-Micrographic Surgery, Allopathic & Osteopathic Physicians / Dermatology. Allopathic & Osteopathic Physicians / Dermatology is his primary health care specialty. Long, Michael David can be contacted via phone (806) 749-7933.

Contact Information

Primary practice address
6012 82Nd St Ste 15 Lubbock TX 79424-3671
Fax: (806) 749-6117
Website:

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / MOHS-Micrographic Surgery 207ND0101X J6551 Texas
Allopathic & Osteopathic Physicians / Dermatology 207N00000X J6551 Texas

Profile Details

NPI number 1386676542
LBN Legal business name Long, Michael David
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jul 7th, 2006
Last updated May 17th, 2023 - 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 1386676542 NPPES
Texas MEDICAID 046852201

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