| Herbert W Long | |
|
417 River Drive Irvine KY 40336 | |
| (606) 723-0399 | |
| (606) 723-0379 |
| Full Name | Herbert W Long |
|---|---|
| Speciality | Clinic/center - Rural Health |
| Location | 417 River Drive, Irvine, Kentucky |
| Authorized Official Name and Position | Herbert W Long (PHYISICAN) |
| Authorized Official Contact | 6067230399 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Herbert W Long 417 River Drive Irvine KY 40336 Ph: (606) 723-0399 | Herbert W Long 417 River Drive Irvine KY 40336 Ph: (606) 723-0399 |
| NPI Number | 1770705873 |
|---|---|
| Provider Enumeration Date | 05/02/2007 |
| Last Update Date | 09/16/2010 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1770705873 | NPI | - | NPPES |
| 35001262 | Medicaid | KY | |
| 31482 | Other | KY | LICENSE |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QR1300X | Clinic/center - Rural Health | 31482 (Kentucky) | Primary |
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