MEDICARE: DR. KATHLEEN A. 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
1	207RH0003X	Hematology & Oncology Physician	038549	GA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
4	1043215403	OTHER	GA	NPI NUMBER
5	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
6	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
7	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
8	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
9	0741780009	OTHER	GA	SUPPLIER NPI NUMBER (CANTON)
10	1801924857	OTHER	GA	SUPPLIER NPI NUMBER (JASPER)

General Provider Information

NPI Number	:	1043215403
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. KATHLEEN A. LONG MD

Provider Business Mailing Address
First Line	:	531 ROSELANE ST NW STE 710
Second Line	:
City	:	MARIETTA
State	:	GA
Zip	:	30060-6975
Country	:	US
Telephone Number	:	678-331-3297
Fax Number	:	678-581-7187

Provider Business Practice Location Address
First Line	:	144 BILL CARRUTH PKWY STE 3100
Second Line	:
City	:	HIRAM
State	:	GA
Zip	:	30141-3819
Country	:	US
Telephone Number	:	678-363-1940
Fax Number	:	678-581-7110

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/14/2005
Last Update Date	:	04/17/2019

Similar Medicare Providers

1184603045 — MRS. DONNA VAN BLADEL WALL NP
Practice Location Address:

144 BILL CARRUTH PKWY STE 3100
HIRAM, GA
30141-3819

Practice Phone: 678-363-1940
Practice Fax: 678-581-7110

1932374980 — DR. ARON ETHIOPIA KEFELA MD
Practice Location Address:

144 BILL CARRUTH PKWY STE 3100
HIRAM, GA
30141-3819

Practice Phone: 678-363-1940
Practice Fax: 678-581-7110

1437485968 — MELISSA SUZANNE BURROUGHS MD
Practice Location Address:

144 BILL CARRUTH PKWY STE 4200
HIRAM, GA
30141-3819

Practice Phone: 770-424-6893
Practice Fax:

1851688410 — SAMEER ARORA MBBS
Practice Location Address:

144 BILL CARRUTH PKWY STE 4200
HIRAM, GA
30141-3819

Practice Phone: 678-324-4444
Practice Fax: 770-528-9932

1679830988 — VAIBHAV AMIN M.D.
Practice Location Address:

144 BILL CARRUTH PKWY STE 4200
HIRAM, GA
30141-3819

Practice Phone: 678-324-4444
Practice Fax: 770-528-9932

1235513607 — DR. WILLIAM L FOREHAND III M.D.
Practice Location Address:

144 BILL CARRUTH PKWY STE 3100
HIRAM, GA
30141-3819

Practice Phone: 678-363-1940
Practice Fax: 678-581-7110

Directions to “ DR. KATHLEEN A. LONG MD” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.