Provider Demographics
NPI:1356361620
Name:FURLONG, DENNIS GERARD (DO)
Entity type:Individual
Prefix:DR
First Name:DENNIS
Middle Name:GERARD
Last Name:FURLONG
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:455 W MCPHERSON HWY
Mailing Address - Street 2:
Mailing Address - City:CLYDE
Mailing Address - State:OH
Mailing Address - Zip Code:43410-1132
Mailing Address - Country:US
Mailing Address - Phone:419-547-8555
Mailing Address - Fax:419-547-9119
Practice Address - Street 1:455 W MCPHERSON HWY
Practice Address - Street 2:
Practice Address - City:CLYDE
Practice Address - State:OH
Practice Address - Zip Code:43410-1132
Practice Address - Country:US
Practice Address - Phone:419-547-8555
Practice Address - Fax:419-547-9119
Is Sole Proprietor?:No
Enumeration Date:2006-07-20
Last Update Date:2023-11-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH5851207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0954196Medicaid
OHF74899Medicare UPIN
OH0954196Medicaid