Dr. Larry Keith Long
Oral and Maxillofacial Surgeon Oral & Maxillofacial Surgeon
2624 Jenks Ave Ste 1
Panama City
, Florida 32405
Dr. Larry Keith Long
Oral and Maxillofacial Surgeon Oral & Maxillofacial Surgeon
2624 Jenks Ave Ste 1
Panama City
, Florida 32405
(210) 667-5171
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About
Features
Specialties
- Oral and Maxillofacial Surgeon
- Oral & Maxillofacial Surgeon
Languages spoken
- English
Location
First Address
- Dr. Larry Keith Long
- 2624 Jenks Ave Ste 1
- Panama City, FL
- Zip : 32405-4311
- Phone : (210) 667-5171
Second Address
- Dr. Larry Keith Long
- 2624 Jenks Ave Ste 1
- Panama City, FL
- Zip : 32405
- Phone : (210) 667-5171
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Scope of Practice
| Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
|---|---|---|---|---|
| Y | 1223S0112X | Oral and Maxillofacial Surgeon | 23649 | TX |
| N | 1223S0112X | Oral and Maxillofacial Surgeon | 6538 | NC |
| N | 1223S0112X | Oral and Maxillofacial Surgeon | DN23806 | FL |
| N | 204E00000X | Oral & Maxillofacial Surgeon | DN23806 | FL |
National Provider Identifier
| NPI | 1275527137 |
|---|---|
| Provider Name | Dr. Larry Keith Long |
| First Address | Panama City, FL 32405-4311 |
| Second Address | Panama City, FL 32405 |
| Gender | M |
| NPI Entity type | Individual |
| Is Sole Proprietor | No |
| Is Organization Subpart | N/A |
| Enumeration Date | 07/09/2005 |
| Last Update Date | 30/11/2020 |
NPI Footnotes
What is the National Provider Identifier (NPI)
Provider Location Address
Provider Mailing Address
Entity Type Code
1= Person: individual human being who furnishes health care;
2= Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)
What is a Subpart?
Provider Other Organization Name
1 = former name;
2 = professional name;
3 = doinq business as (d/b/ a) name;
4 = former legal business name;
5 = other.