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1861436321
DENNIS LONG
JACKSON, MS
NPI
1861436321
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
363L00000X Nurse Practitioner
(Licence: MS R851248)
Enumeration Date
2006-06-15
Last Update Date
2015-02-23
Business Address
-- DENNIS LONG NP
1850 CHADWICK DR
JACKSON, MS 39204-3404
Phone number: 904-805-1300
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Mailing Address
-- DENNIS LONG NP
PO BOX 75473
BALTIMORE, MD 21275-5473
Phone number: 904-805-1300
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