Provider Demographics
NPI:1538375613
Name:LONG, JAMES SPENCER (MD)
Entity type:Individual
Prefix:
First Name:JAMES
Middle Name:SPENCER
Last Name:LONG
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:PO BOX 110
Mailing Address - Street 2:404 CARLYLE
Mailing Address - City:ALMA
Mailing Address - State:NE
Mailing Address - Zip Code:68920
Mailing Address - Country:US
Mailing Address - Phone:308-928-2525
Mailing Address - Fax:308-928-2175
Practice Address - Street 1:404 CARLYLE ST
Practice Address - Street 2:
Practice Address - City:ALMA
Practice Address - State:NE
Practice Address - Zip Code:68920-2078
Practice Address - Country:US
Practice Address - Phone:308-928-2525
Practice Address - Fax:308-928-2175
Is Sole Proprietor?:No
Enumeration Date:2007-05-15
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NE9651207Q00000X
IA31426207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
9651OtherNE
31426OtherIOWA LIC
31426OtherIOWA LIC
AL3976771OtherDEA
NE87890L0Medicare ID - Type Unspecified