Healthcare Provider Details

I. General information

NPI: 1013828375
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: 09/15/2026
Certification Date: 09/15/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1365 CLIFTON RD BLDG C FLOOR 2
ATLANTA GA
30322-1013
US

IV. Provider business mailing address

1365 CLIFTON RD BLDG C FLOOR 2
ATLANTA GA
30322-1013
US

V. Phone/Fax

Practice location:
  • Phone: 404-686-8143
  • Fax:
Mailing address:
  • Phone: 404-686-8143
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208200000X
TaxonomyPlastic Surgery Physician
License Number
License Number State

VIII. Authorized Official

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