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1134495484
KATHERINE MARIE LONG
JACKSON, MS
NPI
1134495484
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
363AS0400X Physician Assistant, Surgical
(Licence: MS TPA0023)
Enumeration Date
2012-03-30
Last Update Date
2018-03-29
Business Address
KATHERINE MARIE LONG PA
1225 N STATE ST SURGERY
JACKSON, MS 39202-2064
Phone number: 601-968-7047
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Mailing Address
KATHERINE MARIE LONG PA
965 RIDGE LAKE BLVD STE 103
MEMPHIS, TN 38120-9446
Phone number: 901-227-3255
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