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Contact Information

ROBERT C LONG, M.D., PHARMD
2500 N STATE ST
JACKSON, MS39216-4500
 Phone: 601-984-5601
 Fax:
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Advanced Heart Failure & Transplant Cardiology

207RA0001X 11 Physician/Internal Medicine
 

Cardiovascular Disease

207RC0000X 11 Physician/Internal Medicine
 

Internal Medicine

207R00000X 11 Physician/Internal Medicine
 

Pharmacist

183500000X
Indicates primary specialty

NPI Profile & details for ROBERT C LONG · (Male)

NPI Number 1639383532
Status Active
Credentials M.D., PHARMD
Entity Individual
Enumeration date 05/09/2007
Last updated 06/06/2017 - About 9 years ago
Sole proprietor 1 No
Identifiers
  • MS License # 19752
  • MS License # E09167
  • AL Medicaid 133721
  • LA Medicaid 2406639
  • MS Medicaid 00121925
  • MS Other P01330224 RAILROAD MEDICARE PTAN
Hospital affiliation(s)
  • MISSISSIPPI BAPTIST MEDICAL CENTER - (Acute Care)
    1225 N STATE ST
    JACKSON, MS 39202
  • NORTH MISSISSIPPI MEDICAL CENTER - (Acute Care)
    830 S GLOSTER
    TUPELO, MS 38801
  • ST DOMINIC-JACKSON MEMORIAL HOSPITAL - (Acute Care)
    969 LAKELAND DR
    JACKSON, MS 39216
  • UNIVERSITY OF MISSISSIPPI MED CENTER - (Acute Care)
    2500 N STATE ST
    JACKSON, MS 39216
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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