Dr Benjamin Daniel Long, MD | |
800 E Carpenter St, Springfield, IL 62769-4699 | |
(217) 544-6464 | |
Not Available |
Full Name | Dr Benjamin Daniel Long |
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Gender | Male |
Speciality | Radiology - Diagnostic Radiology |
Location | 800 E Carpenter St, Springfield, Illinois |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1043702392 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
2085R0202X | Radiology - Diagnostic Radiology | 313938 (North Carolina) | Secondary |
2085R0202X | Radiology - Diagnostic Radiology | 125.071892 (Illinois) | Primary |
Entity Name | Duke Health Integrated Practice Inc |
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Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1205553369 PECOS PAC ID: 8325412737 Enrollment ID: O20230327002247 |
Mailing Address | Practice Location Address |
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Dr Benjamin Daniel Long, MD 111 Oakwood Rd, East Peoria, IL 61611-1853 Ph: (309) 740-4272 | Dr Benjamin Daniel Long, MD 800 E Carpenter St, Springfield, IL 62769-4699 Ph: (217) 544-6464 |
Dr. Christopher John Norbet, MD Radiology Medicare: Accepting Medicare Assignments Practice Location: 3050 Montvale Dr Ste A, Springfield, IL 62704 Phone: 217-726-8096 | |
Sandra Scroggins, MD Radiology Medicare: Medicare Enrolled Practice Location: 800 E Carpenter St, Springfield, IL 62769 Phone: 217-814-5178 Fax: 217-757-6458 | |
Dr. Terence Edward Wade, M.D. Radiology Medicare: Accepting Medicare Assignments Practice Location: 800 E Carpenter St, Springfield, IL 62769 Phone: 217-544-6464 | |
Benjamin Walker Fischer-valuck, MD Radiology Medicare: Accepting Medicare Assignments Practice Location: 701 N 1st St., Springfield, IL 62781 Phone: 217-528-7541 | |
Kevin Coakley, MD Radiology Medicare: Accepting Medicare Assignments Practice Location: 3050 Montvale Dr Ste A, Springfield, IL 62704 Phone: 217-726-8096 | |
Ronald Hidalgo, MD Radiology Medicare: Accepting Medicare Assignments Practice Location: 3050 Montvale Dr, Ste A, Springfield, IL 62704 Phone: 720-848-0000 Fax: 720-848-0000 |