Individual
DR. ELIZABETH BROMAN LONG
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
11 CHARLIE MORRIS RD, COLBERT, GA 30628-2445
(706) 788-2127
(706) 788-2815
Mailing address
PO BOX 459, COLBERT, GA 30628-0459
(706) 788-3234
(706) 788-2936
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
069308
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
003134590A
—
GA
Enumeration date
04/09/2010
Last updated
08/06/2016
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