Long, Brent M

Long, Brent M is an individual health care provider with primary practice located at 2401 Park Dr Ste 101 , Harrisburg PA 17110-9303. He recently has 3 registered licenses in different health care specialties including Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant, Physician Assistants & Advanced Practice Nursing Providers / Medical, Physician Assistants & Advanced Practice Nursing Providers / Surgical. Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant is his primary health care specialty. Long, Brent M can be contacted via phone (717) 686-9842.

Contact Information

Primary practice address
2401 Park Dr Ste 101 Harrisburg PA 17110-9303
Phone: (717) 686-9842
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant 363A00000X 1501096 Kansas
Physician Assistants & Advanced Practice Nursing Providers / Medical 363AM0700X MA001513L Pennsylvania
Physician Assistants & Advanced Practice Nursing Providers / Medical 363AM0700X 1501096 Kansas
Physician Assistants & Advanced Practice Nursing Providers / Surgical 363AS0400X 1501096 Kansas
Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant 363A00000X OA002700 Pennsylvania

Profile Details

NPI number 1508808528
LBN Legal business name Long, Brent M
Credentials Physician Assistant (PA)
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 12th, 2006
Last updated Apr 29th, 2022 - about 3 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1508808528 NPPES
Kansas MEDICAID 200366520A

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