Individual
CHARLES WYATT LONG
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
212 THOMPSON ST STE C, HENDERSONVILLE, NC 28792-2895
(704) 576-3356
Mailing address
212 THOMPSON ST STE C, HENDERSONVILLE, NC 28792-2895
(704) 576-3356
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
100276
GA
207XS0114X
Adult Reconstructive Orthopaedic Surgery Physician
Primary
2025-01701
NC
Other
Enumeration date
05/01/2017
Last updated
07/17/2025
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