Provider Demographics
NPI:1427314939
Name:LONG, TOBIAS CHARLES (MD)
Entity type:Individual
Prefix:
First Name:TOBIAS
Middle Name:CHARLES
Last Name:LONG
Suffix:
Gender:
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Mailing Address - Street 1:1496 LITITZ PIKE
Mailing Address - Street 2:
Mailing Address - City:LANCASTER
Mailing Address - State:PA
Mailing Address - Zip Code:17601-6500
Mailing Address - Country:US
Mailing Address - Phone:717-481-3444
Mailing Address - Fax:717-674-6194
Practice Address - Street 1:1496 LITITZ PIKE
Practice Address - Street 2:
Practice Address - City:LANCASTER
Practice Address - State:PA
Practice Address - Zip Code:17601-6500
Practice Address - Country:US
Practice Address - Phone:717-481-3444
Practice Address - Fax:717-674-6194
Is Sole Proprietor?:Yes
Enumeration Date:2012-04-09
Last Update Date:2025-04-22
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
PAMD472504208200000X, 2086S0122X
OH351317232086S0122X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2086S0122XAllopathic & Osteopathic PhysiciansSurgeryPlastic and Reconstructive SurgeryGroup - Single Specialty
No208200000XAllopathic & Osteopathic PhysiciansPlastic SurgeryGroup - Single Specialty