Provider Demographics
NPI:1457457764
Name:LONG, WILLIAM STEVEN (MD)
Entity Type:Individual
Prefix:DR
First Name:WILLIAM
Middle Name:STEVEN
Last Name:LONG
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Gender:M
Credentials:MD
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Mailing Address - Street 1:802 N RIVERSIDE RD
Mailing Address - Street 2:SUITE G 50
Mailing Address - City:SAINT JOSEPH
Mailing Address - State:MO
Mailing Address - Zip Code:64507-2553
Mailing Address - Country:US
Mailing Address - Phone:816-671-4888
Mailing Address - Fax:816-671-4890
Practice Address - Street 1:802 N RIVERSIDE RD
Practice Address - Street 2:SUITE G 50
Practice Address - City:SAINT JOSEPH
Practice Address - State:MO
Practice Address - Zip Code:64507-2553
Practice Address - Country:US
Practice Address - Phone:816-271-6666
Practice Address - Fax:816-271-1300
Is Sole Proprietor?:No
Enumeration Date:2006-09-15
Last Update Date:2017-11-21
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Provider Licenses
StateLicense IDTaxonomies
MOR5N29208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS100119400BMedicaid
MO202888509Medicaid
MO020054316OtherRR MEDICARE
MO7011624Medicare PIN