DoctorDataHub
Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.

BRENTON VAUGHN LONG, D.O.

Active

BRENTON VAUGHN LONG, D.O. is a General Practice healthcare provider located in SHIPPENVILLE, Pennsylvania. NPI 1790751154 is currently active in the NPPES registry. Verify at CMS.

General Practice · SHIPPENVILLE, PA

Registration Details

NPI Number
1790751154
Provider Type
Individual
Gender
Male
NPI Issued
Feb 27, 2006 (20.439478931818 yrs)
Last Updated
May 29, 2008
License
OS004611L (PA)

Practice Information

Address
21159 PAINT BLVD
SUITE 2
SHIPPENVILLE, PA, 162544023
Browse PA providers · Browse ZIP 16254
Phone
8142266770
Fax
8142261015
Primary Specialty
General Practice
208D00000X
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.