DR. MICHAEL SCOTT LONG (NPI# 1043560691) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1043560691 |
| Entity Type | Individual |
| Full Name | DR. MICHAEL SCOTT LONG |
| Credential | D.O. |
| Practice Address |
4920 Ne Stallings Dr Nacogdoches TX 75965-1254 |
| Mailing Address |
Po Box 226 Rowlett TX 75030-0226 |
| Practice Telephone | 9725260340 |
| Practice Fax Number | 9729961857 |
| Mailing Telephone | 9722526034 |
| Mailing Fax Number | 9729961857 |
| Enumeration Date | 2012-09-11 |
| Last Update Date | 2015-12-22 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207ZP0102X |
Pathology Specialization: Anatomic Pathology & Clinical Pathology |
QQ498 | TX | Allopathic & Osteopathic Physicians |
| N | 207ZP0102X |
Pathology Specialization: Anatomic Pathology & Clinical Pathology |
OS015429 | PA | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| TX | 337951302 | 05 | |
| TX | BLUE CROSS BLUE SHIELD | 8EK438 | 01 |
| TX | 337951301 | 05 | |
| TX | BLUE CROSS BLUE SHIELD | 8EM612 | 01 |
| RAILROAD MEDICARE | P01360899 | 01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1912416561 | Michael Paul Long | Social Worker | 14523 Westlake Drive, Lake Oswego, Or 97035, Lake Oswego, OR 97035 | 2017-09-27 |
| 1184096182 | Michael Keith Long | Registered Nurse | 606 N Kanawha St, Beckley, WV 25801-3819 | 2015-10-29 |
| 1679982110 | Michael Long | Pharmacist | 687 150th Ave, Monmouth, IL 61462-8719 | 2014-08-08 |
| 1457545097 | Michael Brandon Long | Counselor | 541 Veloce Trl, Fort Mill, SC 29715-7826 | 2007-08-28 |
| 1700905445 | Michael Ray Long | Acupuncturist | 1879 Portola Rd Ste L, Ventura, CA 93003-8095 | 2007-03-27 |
| 1538234745 | Michael Walter Long | Dentist | 78461 Highway 111, Plaza Dental Group, La Quinta, CA 92253-2076 | 2006-11-22 |
| 1205858578 | Michael Golden Long | Dentist | 7730 N Fresno St, Ste. 102, Fresno, CA 93720-2408 | 2006-07-24 |
| 1043239775 | Michael Arlin Long | Physician Assistant | 450 4th St., Dassel, MN 55325 | 2006-07-19 |
| 1053394700 | Michael Harrison Long | Physician Assistant | 870 Summit Crossing Pl, Gastonia, NC 28054 | 2005-11-28 |
| 1790336998 | Michael Thomas Long | Psychologist | 921 Chester Pike, Sharon Hill, PA 19079-1411 | 2019-09-27 |
| Street Address |
4920 NE STALLINGS DR |
| City | NACOGDOCHES |
| State | TX |
| Zip Code | 75965-1254 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1285630012 | Ronald Homer Hearne | Pathology | 4920 Ne Stallings Dr, Nacogdoches, TX 75965-1254 | 2005-06-27 |
| 1194331876 | Brittni Colleen Andrews | Nurse Practitioner | 4920 Ne Stallings Dr, Nacogdoches, TX 75965-1254 | 2020-09-18 |
| 1699258608 | Hallie Bernard | Dietitian, Registered | 4920 Ne Stallings Dr, Nacogdoches, TX 75965-1254 | 2018-09-14 |
| 1174005805 | Janice Lynn Waggoner | Physical Therapist | 4920 Ne Stallings Dr, Nacogdoches, TX 75965-1254 | 2018-08-29 |
| 1700381761 | Main Street Anesthesia of Texas, Pa | Anesthesiology | 4920 Ne Stallings Dr, Nacogdoches, TX 75965-1254 | 2018-03-29 |
| 1972032670 | Amy Ellizabeth Bagley-krenek | Nurse Practitioner | 4920 Ne Stallings Dr, Nacogdoches, TX 75965-1254 | 2017-06-06 |
| 1346786258 | Hannah Dunahoe | Dietitian, Registered | 4920 Ne Stallings Dr, Nacogdoches, TX 75965-1254 | 2017-01-16 |
| 1316481492 | Stone Fort Inpatient Services Pllc | Physician Assistant | 4920 Ne Stallings Dr, Nacogdoches, TX 75965-1254 | 2016-12-08 |
| 1588037261 | Astral Emergency Physicians, Pllc | Physician Assistant | 4920 Ne Stallings Dr, Nacogdoches, TX 75965-1254 | 2015-11-04 |
| 1568834521 | Bastion Emergency Physicians, Pplc | Physician Assistant | 4920 Ne Stallings Dr, Nacogdoches, TX 75965-1254 | 2015-10-29 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1649839135 | Genoa Healthcare, LLC | Durable Medical Equipment & Medical Supplies | 3824 N University Drive, Suite 103, Nacogdoches, TX 75965 | 2019-06-10 |
| 1518520493 | Billy Jobe | Pharmacist | 917 East Austin, Nacogdoches, TX 75965 | 2019-04-17 |
| 1295217610 | Sarah Ponder | Registered Nurse | 625 Woodway Lane, Nacogdoches, TX 75965 | 2018-09-01 |
| 1083107684 | Aakash Deep Gupta | Dentist | 4610 North St Ste 101b, Nacogdoches, TX 75965 | 2018-06-08 |
| 1679097455 | Emily Morris Taravella | Counselor | 3524 Ne Stallings Drive, Nacogdoches, TX 75965 | 2017-08-02 |
| 1457809949 | Kassey Osborn | Nurse Practitioner | 4920 Ne Stallings Dr., Nacogdoches Medical Center, Nacogdoches, TX 75965 | 2016-09-14 |
| 1629426747 | Lisa Greathouse | Technician, Other | 500 Chincapin, Westville, OK 75965 | 2016-05-31 |
| 1457741704 | Nuch of Texas | Pediatrics | 1305 North Street, Nacogdoches, TX 75965 | 2015-01-26 |
| 1730506031 | Benjamin Patrick Thompson | Obstetrics & Gynecology | 4800 Ne Stallings Dr Ste 106, Nacogdoches, TX 75965 | 2014-03-25 |
| 1255761813 | Kallie Krawietz | Counselor | 2214 N Pecan Street, Nacogdoches, TX 75965 | 2013-11-19 |
| Find all providers in zip 75965 | ||||
| Taxonomy Code | 207ZP0102X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Pathology |
| Specialization | Anatomic Pathology & Clinical Pathology |
| A pathologist deals with the causes and nature of disease and contributes to diagnosis, prognosis and treatment through knowledge gained by the laboratory application of the biologic, chemical and physical sciences. A pathologist uses information gathered from the microscopic examination of tissue specimens, cells and body fluids, and from clinical laboratory tests on body fluids and secretions for the diagnosis, exclusion and monitoring of disease. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definiton added, source added, 7/1/2009: definition reformatted] Additional Resources: American Board of Pathology, 2007. http://www.abpath.org/ This taxonomy code identifies the combined anatomic pathology & clinical pathology route. Board certification for Medical Doctors (MDs) is provided by the American Board of Pathology. To acknowledge the diverse activities in the practice of pathology and to accommodate the interests of individuals wanting to enter the field, the ABP offers primary certification through the following three routes: combined anatomic pathology and clinical pathology, anatomic pathology only and clinical pathology only. Primary certification in anatomic pathology or clinical pathology may be combined with some of the subspecialty certifications. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1063498624 | Alicia Guajardo Murphy | Pathology | 1204 N Mound, Nacogdoches Memorial Hospital Lab, Nacogdoches, TX 75961 | 2005-12-15 |
| 1285630012 | Ronald Homer Hearne | Pathology | 4920 Ne Stallings Dr, Nacogdoches, TX 75965-1254 | 2005-06-27 |
| 1053711804 | Nacogdoches County Hospital District | Pathology | 1204 N Mound St, Nacogdoches, TX 75961 | 2014-08-29 |
| 1720263601 | Irma M Sainz | Pathology | 1204 N Mound St, Nacogdoches, TX 75961-4027 | 2008-01-09 |
| 1689745374 | Alicia G Murphey Md, Pa | Pathology | 1204 N Mound St, Nacogdoches, TX 75961-4027 | 2006-11-13 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1154922235 | Pathology Institute, Pllc | Pathology | 3201 University Dr E Ste 330, Bryan, TX 77802-3484 | 2020-11-04 |
| 1649893900 | Medical Service Consultation Pa | Pathology | 2613 Sir Percival Ln, Lewisville, TX 75056-5710 | 2020-05-21 |
| 1578196358 | Carlos M Torres Md Expert Pathology Consultation Servi | Pathology | 2840 Keller Springs Rd Ste 1104, Carrollton, TX 75006-4876 | 2020-02-19 |
| 1023654191 | Marsha L Eigenbrodt | Pathology | 860 Junction Dr Apt 344, Allen, TX 75013-5244 | 2019-11-22 |
| 1184274508 | Pathzone LLC | Pathology | 11215 Oudney Ct, Richmond, TX 77407-1883 | 2019-09-17 |
| 1184285587 | Vipulkumar P Prajapati | Pathology | 7323 Snowden Rd Apt 3206, San Antonio, TX 78240 | 2019-06-26 |
| 1548793409 | Grant Williams | Pathology | 3551 Roger Brooke Dr # Tx, Jbsa-fort Sam Houston, San Antonio, TX 78234-4504 | 2017-04-07 |
| 1417307448 | James Gaulding | Pathology | 19 Robledo Dr, Dallas, TX 75230-3055 | 2016-06-21 |
| 1386006492 | Audra Robinson | Pathology | 5417 Ridgepass Ln, Mckinney, TX 75071-3082 | 2016-03-28 |
| 1760840730 | Peachy Ridgway Gilmer Jr. | Pathology | 35 Tiel Way, Houston, TX 77019-1509 | 2016-02-05 |
| Find all providers with the same taxonomy | ||||
| City | NACOGDOCHES |
| Zip Code | 75965 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.