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NPI Profile for KATHERINE M LONG in JACKSON, MS.
Specialty |
Taxonomy Code | Specialty Code | Provider Type | |
Surgical |
363AS0400X | 97 | Physician Assistant |
| NPI Number | 1134495484 |
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| Status | Active | |
| Credentials | PA (Physician Assistant) | |
| Entity | Individual | |
| Enumeration date | 03/30/2012 | |
| Last updated | 03/29/2018 - About 8 years ago | |
| Sole proprietor 1 | No | |
| Identifiers |
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| Hospital affiliation(s) |
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KATHERINE M LONG
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KATHERINE M LONG, PA