Organization
COMMERCE RADIOLOGY, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
THAD DEWARD LONG MD (OWNER)
(678) 469-0007
Entity
Organization
Contact information
Practice address
70 MEDICAL CENTER DR, COMMERCE, GA 30529-1078
(706) 335-1420
(864) 223-1396
Mailing address
108 VENTURE CT, GREENWOOD, SC 29649-8558
(864) 223-3070
(864) 223-1396
Taxonomy
Speciality
Code
Description
License number
State
2085U0001X
Diagnostic Ultrasound Physician
Primary
020769
GA
Other
Enumeration date
10/23/2012
Last updated
10/23/2012
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