Keith Eugene Long in Madras - Physician Assistant
Keith Eugene Long - NPI 1467407122
Keith Eugene Long is a Physician Assistant in Madras, Oregon. Keith Eugene Long practices all healthcare services and medical treatments related to Physician Assistant. The NPI Number for Keith Eugene Long is 1467407122. The last update date is 2007-07-09.
Keith Eugene Long's current location address is 76 Ne 12th St, Madras, Oregon. You can contact this provider via phone number 5414753874 and fax number 5414753503. The mailing address for Keith Eugene Long is 76 Ne 12th St, Madras, Oregon. To know further, please read the information below!
Provider Profile Detail
| Provider Name | Keith Eugene Long |
|---|---|
| Address | 76 Ne 12th St, Madras, Oregon |
| Phone Number | 5414753874 |
| Fax Number | 5414753503 |
| Sole Proprietor | X |
| Credentials | PA-C |
NPI Number Detail
| NPI Number | 1467407122 |
|---|---|
| Provider Enumeration Date | 2006-05-23 |
| Last Updated Date | 2007-07-09 |
Provider Mailing Address Detail
| Address | 76 Ne 12th St |
|---|---|
| City | Madras |
| State | Oregon (OR) |
| Post Code | 977411827 |
| Phone Number | 5414753874 |
| Fax Number | 5414753503 |
Provider's Primary Taxonomy Detail
| Speciality | Physician Assistant |
|---|---|
| Taxonomy | 363A00000X |
| Licence No | PA00386 |
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Definition: A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perfor |
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Provider's Other Legacy Identifiers
| Identifier | Identifier Type | Identifier State | Identifier Issuer |
|---|---|---|---|
| 150563 | OR | -- |
Post Comment/ Review Below
What is the unique identifier code issued to Keith Eugene Long by the Centers for Medicare & Medicaid Services (CMS)?
The Keith Eugene Long has been assigned the NPI (National Provider Identifier) 1467407122. This 10-digit code serves as a unique identification number for healthcare providers, issued by the CMS.
Could you please share the complete physical address where Keith Eugene Long is geographically located?
The Keith Eugene Long is physically situated at the following location: 76 Ne 12Th St, Madras, OR, 977411827.
What is Keith Eugene Long's area of specialization, and what is the corresponding taxonomy classification code for this field of practice?
The specialized area of practice for Keith Eugene Long is Physician Assistant, and the taxonomy code that categorizes this field of expertise is 363A00000X.
On what date did the Keith Eugene Long receive the assignment of its 1467407122 from the Centers for Medicare & Medicaid Services?
The Keith Eugene Long was issued its 1467407122 by the Centers for Medicare & Medicaid Services on 2006-05-23.
As of what date were the Keith Eugene Long's details last updated?
The information pertaining to the Keith Eugene Long, including its address, specialty, and other details, was most recently updated on 2007-07-09.