| Organization Name: | DR PAUL LONG, LLC |
| NPI Number: | 1205233442 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | PAUL M LONG (OWNER) |
| Mailing Address: | 89 Main St Hilton Head |
| State: | SC US |
| Postal Code: | 299266613 |
| Phone Number: | 8436815305 |
| Fax Number: | 8436895210 |
| NPI Enumeration Date: | 12/03/2014 |
| NPI Last Update Date: | 07/30/2015 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 208D00000X |
| License Number: | 8178 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | SC |
| Taxonomy Type: | Allopathic & Osteopathic Physicians |
| Taxonomy Classification: | General Practice |
| Taxonomy Specialization: | |
| Taxonomy Definition: | |