Individual
KATHRYN ELIZABETH LONG
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
1338 HUNDRED OAKS DR, SUITE B, CHARLOTTE, NC 28217-4051
(704) 910-2250
(704) 817-8539
Mailing address
1827 CHESTNUT AVE, CHARLOTTE, NC 28205-3017
(704) 910-2250
(704) 817-8539
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
200100065
NC
207QA0505X
Adult Medicine Physician
Primary
200100065
NC
Other
Enumeration date
08/05/2006
Last updated
04/20/2017
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