Individual
JOSEPH BLAKE LONG
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
4750 WATERS AVE, SUITE 512, SAVANNAH, GA 31404-6200
(912) 350-8085
(912) 350-3703
Mailing address
4700 WATERS AVE, 2ND FLOOR GA EAR, SAVANNAH, GA 31404-6220
(912) 988-5050
(912) 988-5013
Taxonomy
Speciality
Code
Description
License number
State
2080P0202X
Pediatric Cardiology Physician
Primary
040143
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000666322A
—
GA
Enumeration date
08/23/2006
Last updated
12/04/2012
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