Provider Demographics
NPI:1013081843
Name:LONG, HUGH D (DC)
Entity type:Individual
Prefix:DR
First Name:HUGH
Middle Name:D
Last Name:LONG
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:202 7TH AVENUE
Mailing Address - Street 2:
Mailing Address - City:ATMORE
Mailing Address - State:AL
Mailing Address - Zip Code:36502-2604
Mailing Address - Country:US
Mailing Address - Phone:251-368-4343
Mailing Address - Fax:251-368-4343
Practice Address - Street 1:202 7TH AVENUE
Practice Address - Street 2:
Practice Address - City:ATMORE
Practice Address - State:AL
Practice Address - Zip Code:36502-2604
Practice Address - Country:US
Practice Address - Phone:251-368-4343
Practice Address - Fax:251-368-4343
Is Sole Proprietor?:No
Enumeration Date:2006-11-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL687111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL51070086Medicare UPIN
ALT69492Medicare ID - Type Unspecified