Long, William Broughton

Long, William Broughton is an individual health care provider with primary practice located at 501 N Graham Suite # 580, Portland OR 97227. He recently has only one registered license in Allopathic & Osteopathic Physicians / Trauma Surgery, which is considered as his primary health care specialty. Long, William Broughton can be contacted via phone (503) 528-0704.

Contact Information

Primary practice address
501 N Graham Suite # 580 Portland OR 97227
Fax: (503) 528-0708
Website:

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Trauma Surgery 2086S0127X MD13786 Oregon
Allopathic & Osteopathic Physicians / Trauma Surgery 2086S0127X MD00023470 Washington

Profile Details

NPI number 1598735490
LBN Legal business name Long, William Broughton
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jan 24th, 2006
Last updated Jul 8th, 2007 - about 17 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 1598735490 NPPES
Oregon MEDICAID 290536

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