Individual
PAIGE LONG
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
101 JUDGE TANNER BLVD STE 300, COVINGTON, LA 70433-7506
(985) 888-8750
(985) 888-8760
Mailing address
101 JUDGE TANNER BLVD STE 300, COVINGTON, LA 70433-7506
(985) 888-8750
(985) 888-8760
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2583212
—
LA
Enumeration date
09/23/2019
Last updated
02/13/2023
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