Provider Demographics
NPI:1164485488
Name:LONG, JAMES E (MD)
Entity Type:Individual
Prefix:DR
First Name:JAMES
Middle Name:E
Last Name:LONG
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:8316 ARLINGTON BLVD STE 650
Mailing Address - Street 2:
Mailing Address - City:FAIRFAX
Mailing Address - State:VA
Mailing Address - Zip Code:22031-5216
Mailing Address - Country:US
Mailing Address - Phone:703-888-2565
Mailing Address - Fax:703-573-0664
Practice Address - Street 1:8316 ARLINGTON BLVD STE 650
Practice Address - Street 2:
Practice Address - City:FAIRFAX
Practice Address - State:VA
Practice Address - Zip Code:22031-5216
Practice Address - Country:US
Practice Address - Phone:703-888-2565
Practice Address - Fax:703-573-0664
Is Sole Proprietor?:No
Enumeration Date:2006-04-08
Last Update Date:2022-07-21
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
VA0101059000207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA00X172M06Medicare UPIN
DC007157M75Medicare UPIN