Individual
ERIC TANNER LONG
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
FNP
Contact information
Practice address
104 BURNEY DR, FLOWOOD, MS 39232-6621
(601) 987-8200
(601) 987-8211
Mailing address
PO BOX 30594, CHARLOTTE, NC 28230-0594
(601) 987-8200
(601) 987-8211
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
902946
MS
Other
Enumeration date
10/29/2018
Last updated
09/08/2019
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