Provider Demographics
NPI:1922212729
Name:LONG, JOSHUA WILLIAM (MD)
Entity Type:Individual
Prefix:DR
First Name:JOSHUA
Middle Name:WILLIAM
Last Name:LONG
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:9695 S YOSEMITE ST STE 285
Mailing Address - Street 2:
Mailing Address - City:LONE TREE
Mailing Address - State:CO
Mailing Address - Zip Code:80124-2890
Mailing Address - Country:US
Mailing Address - Phone:303-269-4370
Mailing Address - Fax:303-269-4371
Practice Address - Street 1:9800 MT PYRAMID CT STE 300
Practice Address - Street 2:
Practice Address - City:ENGLEWOOD
Practice Address - State:CO
Practice Address - Zip Code:80112-2667
Practice Address - Country:US
Practice Address - Phone:303-269-4370
Practice Address - Fax:303-269-4371
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-10
Last Update Date:2021-03-12
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
CO0051485208600000X
AL27181208600000X
CO51485208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208600000XAllopathic & Osteopathic PhysiciansSurgeryGroup - Single Specialty