Long, Gordon David

Long, Gordon David is an individual health care provider with primary practice located at 715 Richland Mall , Ontario OH 44906-3802. He recently has only one registered license in Allopathic & Osteopathic Physicians / Family Medicine, which is considered as his primary health care specialty. Long, Gordon David can be contacted via phone (419) 529-6195.

Contact Information

Primary practice address
715 Richland Mall Ontario OH 44906-3802
Fax:
Website:

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X 35-04-9038L Ohio

Profile Details

NPI number 1487769766
LBN Legal business name Long, Gordon David
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Aug 20th, 2006
Last updated Jul 5th, 2022 - about 3 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.

Request for update

Identifiers

StateTypeNumberIssuer
All States NPI 1487769766 NPPES
Ohio MEDICAID 0537762

Popular Providers