Kelly Lynn Long is a Medical in Plymouth, Michigan. Kelly Lynn Long practices all healthcare services and medical treatments related to Medical. The NPI Number for Kelly Lynn Long is 1568623338. The last update date is 2022-05-05.
Kelly Lynn Long's current location address is 500 Ross St, Plymouth, Michigan. You can contact this provider via phone number 7343417767 and fax number 7348933131. The mailing address for Kelly Lynn Long is 500 Ross St, Plymouth, Michigan. To know further, please read the information below!
Provider Profile Detail
| Provider Name | Kelly Lynn Long |
|---|---|
| Address | 500 Ross St, Plymouth, Michigan |
| Phone Number | 7343417767 |
| Fax Number | 7348933131 |
| Sole Proprietor | Y |
| Credentials | PA-C |
NPI Number Detail
| NPI Number | 1568623338 |
|---|---|
| Provider Enumeration Date | 2008-06-24 |
| Last Updated Date | 2022-05-05 |
Provider Mailing Address Detail
| Address | 500 Ross St |
|---|---|
| City | Plymouth |
| State | Michigan (MI) |
| Post Code | 481702206 |
| Phone Number | 7343417767 |
| Fax Number | 7348933131 |
Provider's Primary Taxonomy Detail
| Speciality | Medical |
|---|---|
| Taxonomy | 363Am0700X |
| Licence No | 5601003518 |
|
Definition: A licensed healthcare professional who practices medicine under physician supervision focusing on medical diagnoses and treatment. |
|
Provider's Other Legacy Identifiers
| Identifier | Identifier Type | Identifier State | Identifier Issuer |
|---|---|---|---|
| 5601003518 | MI | MICHIGAN LICENSE |
Post Comment/ Review Below
What is the unique 10-digit identifier code assigned to Kelly Lynn Long by the Centers for Medicare & Medicaid Services?
The Kelly Lynn Long has been issued the NPI (National Provider Identifier) 1568623338 by the CMS (Centers for Medicare & Medicaid Services), which serves as a unique identification number for healthcare providers.
Could you please provide the complete physical location address of Kelly Lynn Long?
The Kelly Lynn Long is physically situated at 500 Ross St, in the city of Plymouth, state of MI, with the postal code 481702206.
What is Kelly Lynn Long's primary field of medical specialization, and what is the corresponding taxonomy classification code for this area of expertise?
The primary field of medical specialization for Kelly Lynn Long is Medical, and the taxonomy classification code that categorizes this area of expertise is 363Am0700X.
On what date did the Centers for Medicare & Medicaid Services originally issue the 1568623338 to Kelly Lynn Long?
The Centers for Medicare & Medicaid Services originally issued the 1568623338 to Kelly Lynn Long on 2008-06-24.
As of what date was the information regarding Kelly Lynn Long, such as address, specialty, and other details, last verified and confirmed to be up-to-date?
The information related to Kelly Lynn Long, including its address, specialty, and other relevant details, was last verified and confirmed to be up-to-date on 2022-05-05.
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