Mary Lavonne Long (NPI# 1295877033, PAC ID# 8325227705) is a physician enrolled in Centers for Medicare & Medicaid Services (CMS). The primary specialty is NURSE PRACTITIONER.
| Nation Provider ID (NPI) | 1295877033 |
| PAC ID by PECOS | 8325227705 |
| Professional Enrollment ID | I20110201000550 |
| Full Name | Mary Lavonne Long |
| Organization Legal Name | WELLSTAR MEDICAL GROUP, LLC |
| Address |
3825 Medical Park Dr Austell GA 30106-6831 |
| Gender | F |
| Graduation Year | 2000 |
| Primary Specialty | NURSE PRACTITIONER |
| Group Practice PAC ID | 6709065402 |
| Number of Group Practice Members | 1320 |
| Accepts Medicare Assignment | Y |
| Address | Phone | Organization |
|---|---|---|
| 3825 Medical Park Dr, Austell, GA 30106-6831 | WELLSTAR MEDICAL GROUP, LLC | |
| 9280 Hwy 5 H, Douglasville, GA 30134-1501 | 7709499590 | WELLSTAR MEDICAL GROUP, LLC |
| 5150 Stilesboro N W Rd, Suite 220, Kennesaw, GA 30152-7742 | 7704248222 | WELLSTAR MEDICAL GROUP, LLC |
| Organization Legal Name | WELLSTAR MEDICAL GROUP, LLC |
| Physicians | 1338 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Phong Hoang Do | Family Medicine | Wellstar Medical Group, LLC | 5150 Stilesboro N W Rd, Suite 220, Kennesaw, GA 30152-7742 |
| Francheska Desravines Alcide | Family Medicine | Wellstar Medical Group, LLC | 687 Marietta Hwy, Canton, GA 30114-2608 |
| Marcus J Gates | Neurosurgery | Wellstar Medical Group, LLC | 625 Church Nest, Marietta, GA 30060-1101 |
| Nimota A Adeboye | Nurse Practitioner | Wellstar Medical Group, LLC | 3886 Princeton Lakes Way Sw, Atlanta, GA 30331-5511 |
| Vanessa Jill Lancaster | Nurse Practitioner | Wellstar Medical Group, LLC | 1360 Upper Hembree Rd, Roswell, GA 30076-1230 |
| Janna Williams-pitts | Psychologist, Clinical | Wellstar Medical Group, LLC | 3805 Cherokee Nwst, Kennesaw, GA 30144-2085 |
| Abhishek Kumar Singh | Family Medicine | Wellstar Medical Group, LLC | 121 Marble Mill N W Rd, Suite 101, Marietta, GA 30060-7959 |
| Khuram Ashraf | Internal Medicine | Wellstar Medical Group, LLC | 6043 Prestley Mill Rd C, Douglasville, GA 30134-2280 |
| Jonathan Noel Dodd | Psychologist, Clinical | Wellstar Medical Group, LLC | 3939 Roswell Rd, Marietta, GA 30062-6285 |
| Matthew Charles Agan | Neurology | Wellstar Medical Group, LLC | 780 Canton Rd Ne, Suite 400, Marietta, GA 30060-7298 |
| Street Address |
3825 MEDICAL PARK DR |
| City | AUSTELL |
| State | GA |
| Zip | 30106-6831 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Michael B Pianksy | Internal Medicine | Wellstar Medical Group, LLC | 3825 Medical Park Dr, Austell, GA 30106-6831 |
| Philicia L Andrews | Internal Medicine | Piedmont Medical Care Corporation | 3825 Medical Park Dr, Suite 301, Austell, GA 30106-6818 |
| Michael Mccray | Certified Registered Nurse Anesthetist (crna) | Southcare Anesthesia Services LLC | 3825 Medical Park Dr, Suite 300, Austell, GA 30106-6831 |
| John A Milner | Certified Registered Nurse Anesthetist (crna) | Southcare Anesthesia Services LLC | 3825 Medical Park Dr, Suite 300, Austell, GA 30106-6831 |
| Jack T Saltz | Family Medicine | Piedmont Medical Care Corporation | 3825 Medical Park Dr, Suite 301, Austell, GA 30106-6818 |
| Kelly B Nix | Nurse Practitioner | Wellstar Medical Group, LLC | 3825 Medical Park Dr, Austell, GA 30106-6831 |
| Saira Adeel | Internal Medicine | Wellstar Medical Group, LLC | 3825 Medical Park Dr, Austell, GA 30106-6831 |
| Erica Moore | Certified Registered Nurse Anesthetist (crna) | Southcare Anesthesia Services LLC | 3825 Medical Park Dr, Suite 300, Austell, GA 30106-6831 |
| Jasmine G Jeffers | Gastroenterology | 3825 Medical Park Dr, Suite 300, Austell, GA 30106-1147 | |
| Amita N Dave | Internal Medicine | Wellstar Medical Group, LLC | 3825 Medical Park Dr, Suite 201, Austell, GA 30106-6831 |
| Find all physicians in the same address | |||
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Kristian Stodghill | Hospice/palliative Care | Wellstar Medical Group, LLC | 4040 Hospital W Dr, Austell, GA 30106 |
| Warren Todd Oberle | Urology | Georgia Urology, Pa | 1700 Hospital Dr, Suite 201, Austell, GA 30106 |
| Bennie Dean Mobley | Optometry | 3999 Austell Rd, Austell, GA 30106-1100 | |
| James V Waldron | Physician Assistant | Piedmont Providers LLC | 3820 Medical Park Dr, Austell, GA 30106-1110 |
| Karen J Moore | Certified Registered Nurse Anesthetist (crna) | Mulkey Anesthesiology Associates, PC | 3870 Medical Park Dr, Austell, GA 30106-1110 |
| Ashley W Crocker | Certified Registered Nurse Anesthetist (crna) | Mulkey Anesthesiology Associates, PC | 3870 Medical Park Dr, Suite 100, Austell, GA 30106-1110 |
| Omar Hajmurad | Anesthesiology | Interventional Spine and Pain Management Center, PC | 3870 Medical Park Dr, Austell, GA 30106-1110 |
| Megan Rutherford | Physician Assistant | Piedmont Providers LLC | 3820 Medical Park Dr, Austell, GA 30106-1110 |
| Tayler Alyse Walker | Certified Registered Nurse Anesthetist (crna) | Mulkey Anesthesiology Associates, PC | 3870 Medical Park Dr, Austell, GA 30106-1110 |
| Melanie D Marshall | Certified Registered Nurse Anesthetist (crna) | Mulkey Anesthesiology Associates, PC | 3870 Medical Park Dr, Austell, GA 30106-1110 |
| Find all physicians in zip 30106 | |||
| City | AUSTELL |
| Zip Code | 30106 |
| Specialty | NURSE PRACTITIONER |
| City + Specialty | AUSTELL + NURSE PRACTITIONER |
Please comment or provide details below to improve the information on Mary Lavonne Long.
| Data Provider | Centers for Medicare & Medicaid Services (CMS) |
| Jurisdiction | Medicare |
This dataset includes 1.12 million groups, individual physicians, and other clinicians currently enrolled in Medicare. Each physician is registered with NPI, PAC ID, full name, specialty, phone, organization, hospital, address, medical school, etc.