Individual provider · Type 1 NPI

Katherine Marie Long, PA

Surgical Physician Assistant · Jackson, MS

NPI number 1134495484 Active

Practice location

1225 N State St, Surgery
Jackson, MS 39202-2064

Call (601) 968-7047 Map

Fax (601) 968-4133

Mailing address

965 Ridge Lake Blvd Ste 103
Memphis, TN 38120-9446

Specialties and licenses

TaxonomyCodeLicense
Surgical Physician Assistant Primary 363AS0400XTPA0023 (MS)

Surgical Physician Assistant: Definition to come...

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About NPI 1134495484

Katherine Marie Long, PA's National Provider Identifier is 1134495484, issued on Mar 30, 2012. The primary taxonomy on file is Surgical Physician Assistant (363AS0400X), and the practice location is in Jackson, MS. The record was last updated on Mar 29, 2018.