Provider Demographics
NPI:1801898622
Name:FURLONG, JOSEPH BRIAN (MD)
Entity type:Individual
Prefix:
First Name:JOSEPH
Middle Name:BRIAN
Last Name:FURLONG
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1111 HAWKINS BOULEVARD
Mailing Address - Street 2:SUITE 2-A
Mailing Address - City:EL PASO
Mailing Address - State:TX
Mailing Address - Zip Code:79925-1848
Mailing Address - Country:US
Mailing Address - Phone:915-771-8346
Mailing Address - Fax:915-771-8347
Practice Address - Street 1:1111 HAWKINS BOULEVARD
Practice Address - Street 2:SUITE 2-A
Practice Address - City:EL PASO
Practice Address - State:TX
Practice Address - Zip Code:79925
Practice Address - Country:US
Practice Address - Phone:915-771-8346
Practice Address - Fax:915-771-8347
Is Sole Proprietor?:Yes
Enumeration Date:2005-08-11
Last Update Date:2016-03-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NM2000-186174400000X
TXK9272174400000X, 2085R0202X, 2085R0204X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
No174400000XOther Service ProvidersSpecialist
No2085R0204XAllopathic & Osteopathic PhysiciansRadiologyVascular & Interventional Radiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX096621006Medicaid
H12747Medicare UPIN
TX096621006Medicaid