| Mason H Long MD PA | |
|
301 Health Park Blvd Ste 325 St Augustine FL 32086-5771 | |
| (904) 824-6164 | |
| (904) 824-0365 |
| Full Name | Mason H Long MD PA |
|---|---|
| Speciality | Internal Medicine |
| Location | 301 Health Park Blvd Ste 325, St Augustine, Florida |
| Authorized Official Name and Position | Mason H Long (PRESIDENT/OWNER) |
| Authorized Official Contact | 9048246164 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Mason H Long MD PA 301 Health Park Blvd Ste 325 St Augustine FL 32086-5771 Ph: (904) 824-6164 | Mason H Long MD PA 301 Health Park Blvd Ste 325 St Augustine FL 32086-5771 Ph: (904) 824-6164 |
| NPI Number | 1710204474 |
|---|---|
| Provider Enumeration Date | 04/21/2010 |
| Last Update Date | 04/21/2010 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1710204474 | NPI | - | NPPES |
| 038939100 | Medicaid | FL |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | (NU) | Primary |
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