Provider Demographics
NPI:1558357608
Name:LONG, WILLIAM M (DO)
Entity Type:Individual
Prefix:DR
First Name:WILLIAM
Middle Name:M
Last Name:LONG
Suffix:
Gender:M
Credentials:DO
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Mailing Address - Street 1:7800 US 131 S STE C
Mailing Address - Street 2:
Mailing Address - City:CADILLAC
Mailing Address - State:MI
Mailing Address - Zip Code:49601-7080
Mailing Address - Country:US
Mailing Address - Phone:231-779-1167
Mailing Address - Fax:231-779-1175
Practice Address - Street 1:7800 US 131 S
Practice Address - Street 2:SUITE C
Practice Address - City:CADILLAC
Practice Address - State:MI
Practice Address - Zip Code:49601-8437
Practice Address - Country:US
Practice Address - Phone:231-779-1167
Practice Address - Fax:231-779-1175
Is Sole Proprietor?:No
Enumeration Date:2005-09-23
Last Update Date:2019-01-03
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
MIWL006859207V00000X
WI30958207V00000X
TXE4488207V00000X
GA021740207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology