| Long Family Practice Llc | |
|
420a W Carolina Ave Hartsville SC 29550 | |
| (803) 968-2066 | |
| (843) 639-8145 |
| Full Name | Long Family Practice Llc |
|---|---|
| Speciality | Family Medicine |
| Location | 420a W Carolina Ave, Hartsville, South Carolina |
| Authorized Official Name and Position | William H Long (PHYSICIAN) |
| Authorized Official Contact | 8039682066 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Long Family Practice Llc 420a W Carolina Ave Hartsville SC 29550-4524 Ph: (803) 968-2066 | Long Family Practice Llc 420a W Carolina Ave Hartsville SC 29550 Ph: (803) 968-2066 |
| NPI Number | 1902347677 |
|---|---|
| Provider Enumeration Date | 03/15/2017 |
| Last Update Date | 05/17/2018 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1902347677 | NPI | - | NPPES |
| GP8306 | Medicaid | SC |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | MD23196 (South Carolina) | Primary |
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