Eric W Long MD PC

Primary specialty

SpecialistTaxonomy code 174400000X

License

10871 Issued in OR

Legal business name

ERIC W LONG MD PC

Practice address

6485 SW Borland Rd
Ste G
Tualatin, OR 97062-9762

Phone

(503) 692-1990

Fax

(503) 692-1992

NPI assigned

Sep 12, 2007

Last updated

Sep 13, 2007By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Eric Long

Title

Owner

Phone

(503) 692-1990

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1189555200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1189641600000",
    "number": "1225223175",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6485 SW BORLAND RD",
            "address_2": "STE G",
            "city": "TUALATIN",
            "state": "OR",
            "postal_code": "970629762",
            "telephone_number": "503-692-1990",
            "fax_number": "503-692-1992"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6485 SW BORLAND RD",
            "address_2": "STE G",
            "city": "TUALATIN",
            "state": "OR",
            "postal_code": "970629762",
            "telephone_number": "503-692-1990",
            "fax_number": "503-692-1992"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ERIC W LONG MD PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-09-12",
        "last_updated": "2007-09-13",
        "status": "A",
        "authorized_official_last_name": "LONG",
        "authorized_official_first_name": "ERIC",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "503-692-1990"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "OR",
            "license": "10871",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Specialist in Tualatin, OR
• Providers in Tualatin, OR by specialty
• Specialist in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 13, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.