| NPI | 1063467884 |
|---|---|
| Former Legal Business Name | RANDY LONG, M.D., P.A. |
| Entity Type | Organization |
| Authorized Contact | PENNY H. LOVELACE Office Manager 336-249-8760 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: NC 24982) |
| Additional Taxonomies | 207LA0401X Anesthesiology, Addiction Medicine (Licence: NC 24982) |
| 207LP2900X Anesthesiology, Pain Medicine (Licence: NC 24982) | |
| 207QA0401X Family Medicine, Addiction Medicine | |
| 207R00000X Internal Medicine | |
| 207RA0401X Internal Medicine, Addiction Medicine | |
| 208VP0000X | |
| Enumeration Date | 2006-05-23 |
| Last Update Date | 2017-02-23 |