Individual
MR. STEPHEN M LONG
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
1025 EXECUTIVE DR, SUITE #100, HIXSON, TN 37343-7916
(423) 870-2030
(423) 877-5363
Mailing address
1025 EXECUTIVE DR, SUITE #100, HIXSON, TN 37343-7916
(423) 870-2030
(423) 877-5363
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
1753
TN
Other
Enumeration date
09/23/2009
Last updated
03/31/2014
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