| Mr Kenneth D Long, | |
|
1251 Ne Elm St, Prineville, OR 97754 | |
| (541) 447-1680 | |
| (541) 447-4670 |
| Full Name | Mr Kenneth D Long |
|---|---|
| Gender | Male |
| Speciality | Physician Assistant |
| Location | 1251 Ne Elm St, Prineville, Oregon |
| Accepts Medicare Assignments | Does not participate in Medicare Program. He may not accept medicare assignment. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1982605911 | NPI | - | NPPES |
| 13503 | Other | CLEAR CHOICE | |
| 93071013397754A001 | Other | TRICARE WEST | |
| 9700113590 | Other | RAILROAD MEDICARE | |
| GRP331 | Other | PROVIDENCE HEALTH PLANS | |
| H3079 | Other | PACIFIC SOURCE | |
| 13503 | Other | COIHS | |
| 205625 | Medicaid | OR |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 363A00000X | Physician Assistant | PA00535 (Oregon) | Primary |
| Mailing Address | Practice Location Address |
|---|---|
| Mr Kenneth D Long, 1251 Ne Elm St, Prineville, OR 97754 Ph: (541) 447-1680 | Mr Kenneth D Long, 1251 Ne Elm St, Prineville, OR 97754 Ph: (541) 447-1680 |
Shannon K Brasher, PA-C Physician Assistant Medicare: Accepting Medicare Assignments Practice Location: 384 Se Combs Flat Rd Ste 1200, Prineville, OR 97754 Phone: 541-447-6263 Fax: 541-447-8724 | |
Brandon W Brasher, P.A. Physician Assistant Medicare: Accepting Medicare Assignments Practice Location: 384 Se Combs Flat Rd, Prineville, OR 97754 Phone: 541-447-8750 Fax: 541-447-8428 | |
Mr. Scott Matthew Light, P.A.-C. Physician Assistant Medicare: Medicare Enrolled Practice Location: 1251 Ne Elm St, Suite 1a, Prineville, OR 97754 Phone: 541-447-1680 Fax: 541-447-4670 | |
Leeann Cheryl Osborne, PA Physician Assistant Medicare: Accepting Medicare Assignments Practice Location: 375 Nw Beaver St, Suite 101, Prineville, OR 97754 Phone: 541-447-1680 Fax: 541-447-4670 | |
Connor James Richardson, Physician Assistant Medicare: Not Enrolled in Medicare Practice Location: 384 Se Combs Flat Rd Ste 1200, Prineville, OR 97754 Phone: 541-447-6263 |