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1871564815
CARL EDWARD LONG
JACKSONVILLE, FL
NPI
1871564815
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Primary Taxonomy
363AM0700X Physician Assistant Medical
(Licence: 1053572)
Enumeration Date
2006-01-28
Last Update Date
2007-07-08
Business Address
MR. CARL EDWARD LONG PA-C
2080 CHILD ST
JACKSONVILLE, FL 32214-5005
Phone number: 912-573-4267
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Mailing Address
MR. CARL EDWARD LONG PA-C
1012 DRAKE FEATHER DR
ORANGE PARK, FL 32065-5209
Phone number: 904-625-7395
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