| Tim Long M.d., Psc | |
|
1320 Andrea St Bowling Green KY 42104-3334 | |
| (270) 746-5455 | |
| (270) 746-5688 |
| Full Name | Tim Long M.d., Psc |
|---|---|
| Speciality | Clinic/Center |
| Location | 1320 Andrea St, Bowling Green, Kentucky |
| Authorized Official Name and Position | Timothy R. Long (PRESIDENT) |
| Authorized Official Contact | 2707465455 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Tim Long M.d., Psc 1320 Andrea St Bowling Green KY 42104-3334 Ph: (270) 746-5455 | Tim Long M.d., Psc 1320 Andrea St Bowling Green KY 42104-3334 Ph: (270) 746-5455 |
| NPI Number | 1417057902 |
|---|---|
| Provider Enumeration Date | 09/24/2006 |
| Last Update Date | 03/06/2008 |
| Medicare PECOS PAC ID | 7810968104 |
|---|---|
| Medicare Enrollment ID | O20040802000733 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1417057902 | NPI | - | NPPES |
| 65936585 | Medicaid | KY | |
| DA8524 | Other | MEDICARE RAILROAD | |
| 000000216368 | Other | BC/BS |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261Q00000X | Clinic/center | (* (Not Available)) | Secondary |
| 261QP2300X | Clinic/center - Primary Care | (* (Not Available)) | Primary |
| Provider Name | Terri H Amos |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1104887314 PECOS PAC ID: 0042233942 Enrollment ID: I20060106000022 |
| Provider Name | Timothy R Long |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1699743567 PECOS PAC ID: 8628049913 Enrollment ID: I20060106000060 |
| Provider Name | Leanne Sims Tooley |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1518589563 PECOS PAC ID: 2769862879 Enrollment ID: I20220707001359 |
| Provider Name | Kristin Lynn Mercer |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1447965140 PECOS PAC ID: 1052766151 Enrollment ID: I20231010001628 |
Verdant Healthcare Llc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 1300 Andrea St, Suite 100, Bowling Green, KY 42104 Phone: 270-780-3546 Fax: 270-780-3547 | |
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Cumberland Family Medical Center, Inc. Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 265 Lovers Lane, Bowling Green, KY 42103 Phone: 844-435-0900 Fax: 270-858-4029 |