| Doctor Name: | MR. JAMES ELDON LONG |
| NPI Number: | 1124165626 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | PA-C |
| License Number: | PA2538 |
| Business Practice Address: | 300a Nw 1st Ave Williston, FL - 326962006 |
| Business Phone Number: | 3525290966 |
| Business Fax Number: | 3525290967 |
| Mailing Address: | 300a N,w, 1st Ave, WILLISTON |
| State: | FL |
| Postal Code: | 326966262 |
| Phone Number: | 3525290966 |
| Fax Number: | 3525290967 |
| NPI Enumeration Date: | 01/31/2007 |
| NPI Last Update Date: | 04/29/2014 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363AM0700X |
| License Number: | PA2538 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | FL |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Physician Assistant |
| Taxonomy Specialization: | Medical |
| Taxonomy Definition: | |