Individual
STEPHEN GENE LONG
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
P.A.
Contact information
Practice address
4881 SUGAR MAPLE DRIVE, WPAFB MEDICAL CENTER, WPAFB, OH 45324
(937) 257-3509
(937) 257-3509
Mailing address
4881 SUGAR MAPLE DRIVE, WPAFB MEDICAL CENTER, WPAFB, OH 45324
(937) 257-3509
(937) 257-3509
Taxonomy
Speciality
Code
Description
License number
State
363AS0400X
Surgical Physician Assistant
Primary
1033659 NCCPA
—
Other
Enumeration date
12/09/2005
Last updated
07/08/2007
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