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Individual

DR. DONALD LOUIS LONGHURST

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
B.S., D.C.

Contact information

Practice address
911 N TENNESSEE ST, STE 105, CARTERSVILLE, GA 30120-8514
(678) 995-8475
Mailing address
2 SHADOW LN, CARTERSVILLE, GA 30120-2321
(678) 525-8583

Taxonomy

Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
CHIR008261
GA
111NS0005X
Sports Physician Chiropractor
CHIR008261
GA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
1102822
ASHN
GA
01
11844411
CAQH
GA
01
52238714-001
BCBS-GA
GA
01
8251342
CIGNA
GA
01
9966131
AETNA
GA
Enumeration date
10/23/2007
Last updated
12/12/2015
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