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NPI Profile for ANTHONY D LONG JR in PINE BLUFF, AR.
Specialty |
Taxonomy Code | Specialty Code | Provider Type | |
Surgical |
363AS0400X | 97 | Physician Assistant |
| NPI # | 1912455387 |
|
| Status | Active | |
| Credentials | CSA | |
| Entity | Individual | |
| Enumeration date | 09/14/2016 | |
| Last updated | 09/14/2016 - About 10 years ago | |
| Sole proprietor 1 | Yes | |
| Identifiers |
|
|
| Hospital affiliation(s) | Not Available |
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ANTHONY D LONG JR
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ANTHONY D LONG JR, CSA