Brenton Vaughn Long, DO is a
General Practice physician based in Shippenville, Pennsylvania. Brenton Vaughn Long is licensed to practice in Pennsylvania (license number OS004611L) and his current practice location is 21159 Paint Blvd, Suite 2, Shippenville, Pennsylvania. He can be reached at his office (for appointments etc.) via phone at
(814) 226-6770.
NPI number for Brenton Vaughn Long is 1790751154 and his current mailing address is 121 Doctors Ln, Clarion, Pennsylvania. He
does not participate in medicare program and thus does not accept medicare assignments. His NPI Number is 1790751154.
Physician's Profile
| Full Name | Brenton Vaughn Long |
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| Gender | Male |
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| Speciality | General Practice |
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| Location | 21159 Paint Blvd, Shippenville, Pennsylvania |
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| Accepts Medicare Assignments | Does not participate in Medicare Program. He may not accept medicare assignment. |
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NPI Data:
- NPI Number: 1790751154
- Provider Enumeration Date: 02/27/2006
- Last Update Date: 05/29/2008
Medical Identifiers
Medical identifiers for Brenton Vaughn Long such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1790751154 | NPI | - | NPPES |
| 0008050560007 | Medicaid | PA | |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
|---|
| 208D00000X | General Practice | OS004611L (Pennsylvania) | Primary |
Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Brenton Vaughn Long is
NOT enrolled with medicare and thus cannot prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
| Mailing Address | Practice Location Address |
|---|
Brenton Vaughn Long, DO
121 Doctors Ln,
Clarion, PA 16214-8515
Ph: (814) 226-3470 | Brenton Vaughn Long, DO
21159 Paint Blvd, Suite 2,
Shippenville, PA 16254-4023
Ph: (814) 226-6770 |
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