Long, Timothy R.

Long, Timothy R. is an individual health care provider with primary practice located at 1320 Andrea St , Bowling Green KY 42104-3334. He recently has only one registered license in Allopathic & Osteopathic Physicians / Family Medicine, which is considered as his primary health care specialty. Long, Timothy R. can be contacted via phone (270) 746-5455.

Contact Information

Primary practice address
1320 Andrea St Bowling Green KY 42104-3334
Phone: (270) 746-5455
Fax: (270) 746-5688
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X 33989 Kentucky

Profile Details

NPI number 1699743567
LBN Legal business name Long, Timothy R.
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Mar 8th, 2006
Last updated Dec 17th, 2009 - about 15 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 1699743567 NPPES
Other 000000216368 ANTHEM BLUE CROSS & BLUE
Other 35L1 ANTHEM BLUE CROSS & BLUE
MEDICAID 64339898 ANTHEM BLUE CROSS & BLUE

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