Provider Demographics
NPI:1669658746
Name:GILLESPIE, DARRIA LONG (MD)
Entity Type:Individual
Prefix:DR
First Name:DARRIA
Middle Name:LONG
Last Name:GILLESPIE
Suffix:
Gender:F
Credentials:MD
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Mailing Address - Street 1:531 ASBURY CIR STE N340
Mailing Address - Street 2:DEPT OF EMERGENCY MEDICINE, ADMINISTRATION
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30322-1006
Mailing Address - Country:US
Mailing Address - Phone:404-778-5975
Mailing Address - Fax:
Practice Address - Street 1:531 ASBURY CIR STE N340
Practice Address - Street 2:DEPARTMENT OF EMERGENCY MEDICINE, ADMINISTRATION
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30322-1006
Practice Address - Country:US
Practice Address - Phone:404-778-5975
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-01-18
Last Update Date:2013-06-12
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MA245722207P00000X
GA69158207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine