DYLAN JASPER LONG

LAFAYETTE, IN
NPI1043848120
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy207P00000X Emergency Medicine
(Licence: IN  01089946A)
Additional Taxonomies390200000X Student in an Organized Health Care Education/Training Program
Enumeration Date2020-04-01
Last Update Date2023-08-02
Business Address
DYLAN JASPER LONG MD
5165 MCCARTY LN
LAFAYETTE, IN 47905-8764
Phone number: 765-448-8000
Mailing Address
DYLAN JASPER LONG MD
250 N SHADELAND AVE
INDIANAPOLIS, IN 46219-4959
Phone number: