BRIAN D LONG (NPI# 1760446181) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1760446181 |
| Entity Type | Individual |
| Full Name | BRIAN D LONG |
| Credential | MD |
| Practice Address |
340 Brandywine Blvd Fayetteville GA 30214-1562 |
| Mailing Address |
3225 Cumberland Blvd Se Suite 900 Atlanta GA 30339-6407 |
| Practice Telephone | 7707197950 |
| Practice Fax Number | 7704601739 |
| Mailing Telephone | 4043512220 |
| Mailing Fax Number | 4043555624 |
| Enumeration Date | 2006-04-13 |
| Last Update Date | 2019-03-19 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207W00000X | Ophthalmology | 043413 | GA | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| GA | 000755521A | 05 | |
| GA | MEDICARE ID | 18BDFDR | 01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1093268039 | Brian Long | Behavioral Analyst | 751a Camino Plz, San Bruno, CA 94066-3401 | 2016-07-26 |
| 1265503585 | Brian Michael Long | Dentist | 22100 Outer Dr, Dearborn, MI 48124-3932 | 2006-11-10 |
| 1013925189 | Brian D Long | Physical Therapist | 10700 Sapp Brothers Dr, Omaha, NE 68138-3823 | 2006-08-04 |
| 1134110257 | Brian Mckinley Long | Surgery | 5425 W Spring Creek Pkwy Ste 140, Plano, TX 75024-4318 | 2005-10-31 |
| 1962023879 | Brian Timothy Long | Counselor | 413 E Dixie Ave Ste 106, Elizabethtown, KY 42701-1162 | 2020-05-01 |
| 1669953345 | Brian Richard Long | Pharmacist | 1945 W Palmetto St Unit 32, Florence, SC 29501-3918 | 2018-08-22 |
| 1962953471 | Brian Long | Counselor | 17070 Se Mcloughlin Blvd, Milwaukie, OR 97267-2115 | 2016-10-19 |
| 1972909422 | Brian Long | Community Health Worker | 344 E 100 S Ste 301, Salt Lake City, UT 84111-1727 | 2014-11-11 |
| 1093052144 | Brian Long | Pharmacist | 51 E Paulding Dr, Dallas, GA 30157-7190 | 2013-01-09 |
| 1629336276 | Brian Pandit Long | Pediatrics | 6303 Little River Tpke Ste 300, Alexandria, VA 22312 | 2012-05-01 |
| Street Address |
340 BRANDYWINE BLVD |
| City | FAYETTEVILLE |
| State | GA |
| Zip Code | 30214-1562 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1912396276 | Eca Optical, LLC | Eyewear Supplier (Equipment, not the service) | 340 Brandywine Blvd, Fayetteville, GA 30214-1562 | 2015-01-09 |
| 1457613655 | Scott Donald Gardner | Ophthalmology | 340 Brandywine Blvd, Fayetteville, GA 30214-1562 | 2012-06-13 |
| 1225092471 | Charles Howell Tucker | Ophthalmology | 340 Brandywine Blvd, Fayetteville, GA 30214-1562 | 2006-04-14 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1548872468 | Phyllis Kelly Wood | Nurse Practitioner | 217 Banks Rd, Suite 31, Fayetteville, GA 30214 | 2020-08-21 |
| 1073139317 | Tyisha Salter Scott | Counselor | 110 Habersham Drive, Suite 142, Fayetteville, GA 30214 | 2020-06-23 |
| 1194341412 | Camille Franncine Bolton | Physical Therapist | 500 Floy Farr Parkway, Suite 303, Fayetteville, GA 30214 | 2020-06-23 |
| 1205465895 | Gillian Vaughan Heard | Physician Assistant | 1275 Ga-54 #201, Fayetteville, GA 30214 | 2020-04-06 |
| 1881234557 | Peach Fits,inc | Mastectomy Fitter | 285 Glynn Street South, Suites 102 and 104, Fayetteville, GA 30214 | 2020-01-10 |
| 1255981072 | Delta Healthcare Providers | Clinic/Center | 1275 W Lanier Ave, #200, Fayetteville, GA 30214 | 2019-09-13 |
| 1861965592 | Hierarchy for Wellness | Specialist | 805 S Glynn St Bldg 127 142, Fayetteville, GA 30214 | 2019-01-04 |
| 1356810634 | Fayette Dental Group PC | Clinic/Center | 720 W Lanier Ave, Fayetteville, GA 30214 | 2018-11-16 |
| 1891263299 | Mattie Mae Farmer Clark | Specialist/Technologist, Other | Piedmont Fayette Hospital, 1255 Highway 54 West, Fayetteville, GA 30214 | 2018-11-05 |
| 1093293607 | Allyson Holland | Pharmacist | 880 Highway 85 South, Fayetteville, GA 30214 | 2018-08-06 |
| Find all providers in zip 30214 | ||||
| Taxonomy Code | 207W00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Ophthalmology |
| An ophthalmologist has the knowledge and professional skills needed to provide comprehensive eye and vision care. Ophthalmologists are medically trained to diagnose, monitor and medically or surgically treat all ocular and visual disorders. This includes problems affecting the eye and its component structures, the eyelids, the orbit and the visual pathways. In so doing, an ophthalmologist prescribes vision services, including glasses and contact lenses. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definiton added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Ophthalmology, 2007. http://www.abop.org/. American Osteopathic Board of Ophthalmology and Otolaryngology, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Ophthalmology. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Ophthalmology and Otolaryngology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1417394404 | Hans Barron Heymann | Ophthalmology | 613 N Willow Ave, Fayetteville, AR 72701-3550 | 2013-05-30 |
| 1770821324 | Ernest Mitchell Singleton | Ophthalmology | 1793 E Manchester Dr, Fayetteville, AR 72703-6224 | 2013-01-16 |
| 1891910618 | Fayette Medical Clinic Optical Shop | Ophthalmology | 101 Yorktown Dr Ste 225, Fayetteville, GA 30214-1568 | 2007-04-16 |
| 1598878571 | Shelby Stephenson | Ophthalmology | 414 Owen Dr, Fayetteville, NC 28304-3416 | 2006-08-16 |
| 1871521625 | Michael George Woodcock | Ophthalmology | 2047 Valleygate Dr, Fayetteville, NC 28304-3688 | 2006-06-29 |
| 1285686865 | Jimmie Wayne Riggins | Ophthalmology | 1726 Metromedical Dr, Fayetteville, NC 28304-3861 | 2006-05-16 |
| 1164473468 | Kellye A Smith | Ophthalmology | 594 E Millsap Rd, Fayetteville, AR 72703-4096 | 2006-05-12 |
| 1639136229 | Shelby A Stephenson | Ophthalmology | 1629 Owen Dr, Fayetteville, NC 28304-3425 | 2006-04-27 |
| 1891757399 | Steven D. Vold | Ophthalmology | 2783 N Shiloh Dr, Fayetteville, AR 72704-6983 | 2006-04-03 |
| 1851395602 | George Leonard Cooper | Ophthalmology | 2139 Valleygate Dr, Ste 101a, Fayetteville, NC 28304-3666 | 2005-06-09 |
| Find all providers in FAYETTEVILLE | ||||
| City | FAYETTEVILLE |
| Zip Code | 30214 |
Please comment or provide details below to improve the information on BRIAN D LONG.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.