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NPI Code Detail

MEDICARE: DR. JUSTIN B LONG MD

MEDICARE: DR. JUSTIN B LONG MD
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207LP3000XPediatric Anesthesiology Physician036.132063IL
2207L00000XAnesthesiology Physician76006GA

General Provider Information

NPI Number : 1770718843
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. JUSTIN B LONG MD
Provider Business Mailing Address
First Line : 2220 N DRUID HILLS RD NE
Second Line :
City : ATLANTA
State : GA
Zip : 30329-3117
Country : US
Telephone Number : 404-785-6670
Fax Number :
Provider Business Practice Location Address
First Line : 2220 N DRUID HILLS RD NE
Second Line :
City : ATLANTA
State : GA
Zip : 30329-3117
Country : US
Telephone Number : 404-785-6670
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/19/2009
Last Update Date : 02/02/2026

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Directions to “ DR. JUSTIN B LONG MD” Practice Location

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