Individual
JOHN LONG
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
1061 HARMON AVE, FORT STEWART, GA 31314-5641
(704) 301-9526
(912) 435-5966
Mailing address
1061 HARMON AVE, FORT STEWART, GA 31314-5641
(704) 301-9526
(912) 435-5966
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
—
—
Other
Enumeration date
03/05/2019
Last updated
03/05/2019
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