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1932676913
ERIC TANNER LONG
FLOWOOD, MS
NPI
1932676913
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
363LF0000X Nurse Practitioner Family
(Licence: MS 902946)
Enumeration Date
2018-10-29
Last Update Date
2019-09-08
Business Address
ERIC TANNER LONG FNP
104 BURNEY DR
FLOWOOD, MS 39232-6621
Phone number: 601-987-8200
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Mailing Address
ERIC TANNER LONG FNP
PO BOX 30594
CHARLOTTE, NC 28230-0594
Phone number: 601-987-8200
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