Individual
DR. EDWARD LARRY LONG III
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
980 SANDERS RD STE 100, CUMMING, GA 30041-5977
(478) 301-2652
Mailing address
1501 MERCER UNIVERSITY DR, MACON, GA 31207-1515
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
95436
GA
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
12/12/2017
Last updated
05/22/2023
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