Long, Timothy E

Long, Timothy E is an individual health care provider with primary practice located at 7691 Poplar Ave , Germantown TN 38138-3904. He recently has only one registered license in Allopathic & Osteopathic Physicians / Emergency Medicine, which is considered as his primary health care specialty. Long, Timothy E can be contacted via phone (901) 516-6970.

Contact Information

Primary practice address
7691 Poplar Ave Germantown TN 38138-3904
Phone: (901) 516-6970
Fax:
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Emergency Medicine 207P00000X 22014 Tennessee

Profile Details

NPI number 1235130097
LBN Legal business name Long, Timothy E
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Aug 2nd, 2005
Last updated Dec 28th, 2007 - about 19 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 1235130097 NPPES
Tennessee MEDICAID 3068840

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