Individual
HAYDEN LONG
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA
Contact information
Practice address
1404 RIVER PL STE 401, BRASELTON, GA 30517-5600
(770) 848-6190
Mailing address
PO BOX 742616, ATLANTA, GA 30374-2616
(770) 219-8420
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
11726
GA
Other
Enumeration date
04/06/2023
Last updated
10/18/2023
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