Healthcare Provider Details

I. General information

NPI: 1265343644
Provider Name (Legal Business Name): CRAWFORD LONG HOSPITAL
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/15/2026
Last Update Date: 09/17/2026
Certification Date: 09/17/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

12 EXECUTIVE PARK DR. 4TH FLOOR
ATLANTA GA
30329
US

IV. Provider business mailing address

12 EXECUTIVE PARK DR. 4TH FLOOR
ATLANTA GA
30329
US

V. Phone/Fax

Practice location:
  • Phone: 404-778-5770
  • Fax:
Mailing address:
  • Phone: 404-778-3444
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207T00000X
TaxonomyNeurological Surgery Physician
License Number
License Number State

VIII. Authorized Official

Name: CARLA D CASHIO
Title or Position: CORPORATE DIRECTOR
Credential:
Phone: 404-686-1811