NPIMap

Organization Active NPI

Alfred M. Long, Jr., O.D., LLC

  • Optometrist
  • Marietta, GA
National Provider Identifier
1720376353
Registry record updated Jul 18, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
OPT001218 Issued in GA
Legal business name
ALFRED M. LONG, JR., O.D., LLC
Practice address
690 Stone House LN NW
Marietta, GA 30064-4700
Phone
(770) 313-7286
NPI assigned
Jul 18, 2011
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 18, 2011

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

Authorized official

Name
Alfred M Long Jr., ODNPI 1891876462
Title
Owner
Phone
(770) 313-7286

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
OptometristGroup: 193400000X SINGLE SPECIALTY GROUP 152W00000X OPT001218 GA Primary

Addresses

Primary practice location

690 Stone House LN NW
Marietta, GA 30064-4700

Mailing address

690 Stone House LN NW
Marietta, GA 30064-4700

National Provider Directory

National Provider Directory

Locations

205 Roadrunner Blvd
La Fayette, GA 30728
Phone (706) 638-4662

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1310947200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1310947200000",
    "number": "1720376353",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "690 STONE HOUSE LN NW",
            "city": "MARIETTA",
            "state": "GA",
            "postal_code": "300644700"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "690 STONE HOUSE LN NW",
            "city": "MARIETTA",
            "state": "GA",
            "postal_code": "300644700",
            "telephone_number": "770-313-7286"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ALFRED M. LONG, JR., O.D., LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-07-18",
        "last_updated": "2011-07-18",
        "status": "A",
        "authorized_official_last_name": "LONG",
        "authorized_official_first_name": "ALFRED",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "770-313-7286",
        "authorized_official_name_suffix": "Jr.",
        "authorized_official_credential": "OD"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": "GA",
            "license": "OPT001218",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Marietta, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 18, 2011; 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.