Longevity Medical Center, PC

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

Legal business name

LONGEVITY MEDICAL CENTER, PC

Practice address

4646 N Shallowford Rd Ste 300
Atlanta, GA 30338-6308

Phone

(678) 736-6383

Fax

(678) 280-6761

NPI assigned

Nov 8, 2018

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Saira Sultan

Title

Doo

Phone

(770) 676-6000

Specialties & licenses 1

Addresses

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1541635200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1541635200000",
    "number": "1124596069",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1551 DUNWOODY VILLAGE PKWY UNIT 888426",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303560115",
            "telephone_number": "678-736-6383",
            "fax_number": "678-280-6761"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4646 N SHALLOWFORD RD STE 300",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303386308",
            "telephone_number": "678-736-6383",
            "fax_number": "678-280-6761"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LONGEVITY MEDICAL CENTER, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-11-08",
        "last_updated": "2018-11-08",
        "status": "A",
        "authorized_official_last_name": "SULTAN",
        "authorized_official_first_name": "SAIRA",
        "authorized_official_title_or_position": "DOO",
        "authorized_official_telephone_number": "770-676-6000"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Robert Anthony Long, DMD
• Sarah Jane Long
• Long'S Drugs of Sandersville, Georgia, Inc.
• Long'S Drugs of Sandersville, Georgia, Inc.
• Longevity Clinical LTC Associates of Georgia, PC
• Longleaf Hospice, LLC
• Jean V Longley, MD
• Longs Drugs of Sandersville Georgia Inc
• Sagar Lonial, M.D.
• Lonnie C. Jenkins MD PC

• Family Medicine Physician in Atlanta, GA
• Providers in Atlanta, GA by specialty
• Family Medicine Physician in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 8, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.