Individual
KYLE DOUGLAS LONG
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
2080 CHILD ST DEPT 5000, JACKSONVILLE, FL 32214-2575
(904) 542-7300
Mailing address
2080 CHILD ST DEPT 5000, JACKSONVILLE, FL 32214-5000
(904) 542-3700
Taxonomy
Speciality
Code
Description
License number
State
208D00000X
General Practice Physician
Primary
0102207472
VA
Other
Enumeration date
03/03/2021
Last updated
03/24/2024
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