Jack Calhoun Long, MD

Primary specialty

Urology PhysicianTaxonomy code 208800000X

License

D7435 Issued in TX

Practice address

1900 Scenic Dr Ste 1114
Georgetown, TX 78626-7724

Phone

(512) 248-2200

Fax

(512) 248-1950

NPI assigned

Nov 2, 2005

Last updated

Nov 1, 2021By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other names 1

• Dr. Jack Calhoun Scott Long Professional name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

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

{
    "created_epoch": "1130889600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1635724800000",
    "number": "1376534917",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8240 N MOPAC EXPY STE 100",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787598869",
            "telephone_number": "512-687-1950"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1900 SCENIC DR STE 1114",
            "city": "GEORGETOWN",
            "state": "TX",
            "postal_code": "786267724",
            "telephone_number": "512-248-2200",
            "fax_number": "512-248-1950"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LONG",
        "first_name": "JACK",
        "middle_name": "CALHOUN",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-11-02",
        "last_updated": "2021-11-01",
        "certification_date": "2021-11-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "TX",
            "license": "D7435",
            "primary": false
        },
        {
            "code": "208800000X",
            "taxonomy_group": "",
            "desc": "Urology",
            "state": "TX",
            "license": "D7435",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JACK",
            "last_name": "LONG",
            "middle_name": "CALHOUN SCOTT",
            "prefix": "DR.",
            "credential": "M.D.",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

• Lone Star Circle of Care
• Lone Star Circle of Care
• Lone Star Circle of Care
• Lone Star Circle of Care (Lone Star Circle of Care at Georgetown Women's Center)
• Lone Star Vein Institute PLLC
• Karen Marie Long, CFNP
• Kathleen Therese Long, AU.D.
• Longhorn Senior Care, LLC (Caring Senior Service of Central Texas)
• David W. Loper, D.C.
• Rafael Lopez, D.C.

• Urology Physician in Georgetown, TX
• Providers in Georgetown, TX by specialty
• Urology Physician in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 1, 2021; 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.