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Organization
MASON H LONG MD PA
Active
Organization
MASON H LONG MD PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MASON H LONG MD (PRESIDENT/OWNER)
(904) 824-6164
Entity
Organization
Contact information
Practice address
301 HEALTH PARK BLVD STE 325, ST AUGUSTINE, FL 32086-5771
(904) 824-6164
(904) 824-0365
Mailing address
301 HEALTH PARK BLVD STE 325, ST AUGUSTINE, FL 32086-5771
(904) 824-6164
(904) 824-0365
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
038939100
—
FL
Enumeration date
04/21/2010
Last updated
04/21/2010
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