Provider Demographics
NPI:1922175322
Name:LONG, CECIL (MD)
Entity Type:Individual
Prefix:
First Name:CECIL
Middle Name:
Last Name:LONG
Suffix:
Gender:M
Credentials:MD
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Other - First Name:
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Other - Last Name:
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Mailing Address - Street 1:1 INDEPENDENCE PLZ STE 810
Mailing Address - Street 2:
Mailing Address - City:BIRMINGHAM
Mailing Address - State:AL
Mailing Address - Zip Code:35209-2647
Mailing Address - Country:US
Mailing Address - Phone:205-307-0484
Mailing Address - Fax:205-278-1447
Practice Address - Street 1:1 INDEPENDENCE PLZ STE 810
Practice Address - Street 2:
Practice Address - City:BIRMINGHAM
Practice Address - State:AL
Practice Address - Zip Code:35209-2647
Practice Address - Country:US
Practice Address - Phone:205-307-0484
Practice Address - Fax:205-278-1447
Is Sole Proprietor?:No
Enumeration Date:2006-11-29
Last Update Date:2018-03-17
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
AL19244207VE0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207VE0102XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyReproductive Endocrinology
Provider Identifiers
StateIdentifier IDID TypeIssuer
ALE66482Medicare UPIN