Paul L Longstreth, M.D.

Primary specialty

Diagnostic Radiology PhysicianTaxonomy code 2085R0202X

License

MD12464 Issued in OR

Practice address

960 N 16TH St
Suite105
Springfield, OR 97477-4175

Phone

(541) 726-4699

Fax

(541) 744-6069

NPI assigned

Dec 22, 2005

Last updated

Jan 4, 2008By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• McKenzie Medical Imaging PC

  dba Willamette Valley Mammography

  • Specialist
  • Springfield, OR
  • NPI 1114969532
  NPD (past)
• Willamette Valley Mammography

  • Specialist
  • Eugene, OR
  • NPI 1821121344
  NPD (past)

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

{
    "created_epoch": "1135209600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1199404800000",
    "number": "1356327258",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "960 N 16TH ST",
            "address_2": "SUITE105",
            "city": "SPRINGFIELD",
            "state": "OR",
            "postal_code": "974774175",
            "telephone_number": "541-726-4699",
            "fax_number": "541-744-6069"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "960 N 16TH ST",
            "address_2": "SUITE105",
            "city": "SPRINGFIELD",
            "state": "OR",
            "postal_code": "974774175",
            "telephone_number": "541-726-4699",
            "fax_number": "541-744-6069"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LONGSTRETH",
        "first_name": "PAUL",
        "middle_name": "L",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-12-22",
        "last_updated": "2008-01-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "OR",
            "license": "MD12464",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "241323",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Alexandre Lockfeld, M.D.
• Mary A Loeb, MEDICAL DOCTOR
• Mya Michelle Lokan, LMT
• Donavan Christopher Long
• Tiffany Nichole Long
• Lonn Robertson DMD PC
• Samantha Jane Loomis, NP
• Tiffany Looney, MS
• Marielle E Lopes, MD
• Karina Lopez

• Diagnostic Radiology Physician in Springfield, OR
• Providers in Springfield, OR by specialty
• Diagnostic Radiology Physician in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 4, 2008; 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.