Long, Stephen E

Long, Stephen E is an individual health care provider with primary practice located at 3231 S National Ave Suite 130, Springfield MO 65807-7304. He recently has only one registered license in Allopathic & Osteopathic Physicians / Nuclear Medicine, which is considered as his primary health care specialty. Long, Stephen E can be contacted via phone (417) 888-5665.

Contact Information

Primary practice address
3231 S National Ave Suite 130 Springfield MO 65807-7304
Phone: (417) 888-5665
Fax: (417) 841-0108
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Nuclear Medicine 207U00000X R6H16 Missouri

Profile Details

NPI number 1629117510
LBN Legal business name Long, Stephen E
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Feb 6th, 2007
Last updated May 24th, 2013 - about 12 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 1629117510 NPPES
Missouri Other 431560263 TRICARE
Missouri Other 81453 TRICARE
Missouri MEDICAID 1629117510 TRICARE
Missouri MEDICAID 138827001 TRICARE
Missouri Other 173098 TRICARE

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