Robert Dale Long, MD

Primary specialty

Dermatology PhysicianTaxonomy code 207N00000X

License

MD016589E Issued in PA

Practice address

3 Hospital Dr
Lewisburg, PA 17837

Phone

(570) 523-1109

Fax

(570) 523-7736

NPI assigned

Apr 12, 2006

Sex

Male

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in PA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1144800000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1282348800000",
    "number": "1003870650",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3 HOSPITAL DR",
            "city": "LEWISBURG",
            "state": "PA",
            "postal_code": "17837",
            "telephone_number": "570-523-1109",
            "fax_number": "570-523-7736"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3 HOSPITAL DR",
            "city": "LEWISBURG",
            "state": "PA",
            "postal_code": "17837",
            "telephone_number": "570-523-1109",
            "fax_number": "570-523-7736"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LONG",
        "first_name": "ROBERT",
        "middle_name": "DALE",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-04-12",
        "last_updated": "2010-08-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "PA",
            "license": "MD016589E",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS",
            "identifier": "02500700",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE SHIELD",
            "identifier": "LO70425",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Taylor Litchard, SLP
• John Little, CRNA
• Mark Lloyd, D.O.
• Amanda L Lockard, CCC-SLP
• Natalie Renee Logan, MS, OTR/L
• Phillip Longnecker, PA-C
• Rachelle Lorson, PTA
• Jeffrey R Lose, OD
• Mary Tate Lotspeich, LCSW
• Daniel J. Lovestrand, M.D.

• Dermatology Physician in Lewisburg, PA
• Providers in Lewisburg, PA by specialty
• Dermatology Physician in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 21, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.