Long, Thad D
Long, Thad D is an sole proprietor health care provider with primary practice located at 1601 Fair Rd Suite 1100, Statesboro GA 30458-1698. He recently has only one registered license in Allopathic & Osteopathic Physicians / Diagnostic Radiology, which is considered as his primary health care specialty. Long, Thad D can be contacted via phone (678) 469-0007.Contact Information
Primary practice address
1601 Fair Rd Suite 1100
Statesboro GA 30458-1698
Phone: (678) 469-0007
Fax: (321) 206-0834
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Diagnostic Radiology | 2085R0202X | 020769 | Georgia |
Profile Details
| NPI number | 1427050368 |
|---|---|
| LBN Legal business name | Long, Thad D |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Aug 11th, 2005 |
| Last updated | Aug 20th, 2012 - about 12 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1427050368 | NPPES |
| Georgia | MEDICAID | 00237157H |
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