Healthcare Provider Details

I. General information

NPI: 1831622273
Provider Name (Legal Business Name): ROBYN ASHLEY LONG D.O.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/04/2017
Last Update Date: 04/30/2026
Certification Date: 04/30/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1207 5TH ST SE
CAIRO GA
39828-3144
US

IV. Provider business mailing address

1207 5TH ST SE
CAIRO GA
39828-3144
US

V. Phone/Fax

Practice location:
  • Phone: 229-231-3727
  • Fax: 229-230-4046
Mailing address:
  • Phone: 229-231-3727
  • Fax: 229-230-4046

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number85628
License Number StateGA
# 2
Primary TaxonomyN
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License Number85628
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: