Provider Demographics
NPI:1407870272
Name:LONG, ROBERT HELTON (MD)
Entity Type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:HELTON
Last Name:LONG
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Gender:M
Credentials:MD
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Mailing Address - Street 1:4131 W LOOMIS RD
Mailing Address - Street 2:SUITE 300
Mailing Address - City:GREENFIELD
Mailing Address - State:WI
Mailing Address - Zip Code:53221-2057
Mailing Address - Country:US
Mailing Address - Phone:414-325-7246
Mailing Address - Fax:414-325-3770
Practice Address - Street 1:1400 MADISON AVE STE 402
Practice Address - Street 2:
Practice Address - City:MANKATO
Practice Address - State:MN
Practice Address - Zip Code:56001-5476
Practice Address - Country:US
Practice Address - Phone:507-625-7246
Practice Address - Fax:507-386-2599
Is Sole Proprietor?:No
Enumeration Date:2006-07-26
Last Update Date:2018-03-23
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Provider Licenses
StateLicense IDTaxonomies
MN48482208100000X, 208VP0014X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208VP0014XAllopathic & Osteopathic PhysiciansPain MedicineInterventional Pain Medicine
No208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & Rehabilitation