Healthcare Provider Details

I. General information

NPI: 1144132424
Provider Name (Legal Business Name): CRAWFORD LONG HOSPITAL
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/21/2026
Last Update Date: 09/21/2026
Certification Date: 09/21/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1605 CHANTILLY DR NE STE 301
ATLANTA GA
30324-3267
US

IV. Provider business mailing address

2201 HENDERSON MILL RD NE
ATLANTA GA
30345-2711
US

V. Phone/Fax

Practice location:
  • Phone: 404-778-3712
  • Fax:
Mailing address:
  • Phone: 404-686-8701
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2086S0129X
TaxonomyVascular Surgery Physician
License Number
License Number State

VIII. Authorized Official

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