Jeffrey Neil Longenecker, PA-C
Physician Assistant, Surgical in Athens, TN. Individual provider (NPI-1).
NPI number1609024140
StatusActive
Last updated in NPPESMar 17, 2018
Details
- NPI
- 1609024140
- Entity type
- Individual (NPI-1)
- Name
- Mr. Jeffrey Neil Longenecker
- Credential
- PA-C
- Sex
- Male
- Sole proprietor
- No
- Enumeration date
- Sep 8, 2008
- Last updated
- Mar 17, 2018
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 363AS0400X | Physician Assistant, Surgical | – | TN | Yes |
| 363A00000X | Physician Assistant | 1655 | TN | |
| 363AM0700X | Physician Assistant, Medical | 1655 | TN |
Practice location
1114 W Madison AveAthens, TN 37303-4150
Phone 423-744-3308 · Fax 423-744-3495
Mailing address
5016 Lewis RdMc Donald, TN 37353-4069
Phone 615-829-3949
Other practice locations
9400 Rhea County Hwy
Dayton, TN 37321-7922
Dayton, TN 37321-7922
Phone 423-775-1121
Is something wrong?
This page shows exactly what the provider filed with NPPES. Only the provider (or their surrogate) can change it, by signing in to NPPES. Our page updates within a day of their change. See how to update NPI information.
Checking a whole list?
Paste up to 5,000 NPIs and download status, name, taxonomy, license and address for each one. Useful for credentialing, billing and pharmacy claim checks.