Dr Hailey Long, OD is a medicare enrolled "Optometrist" provider in Dawson, Georgia. Her current practice location is
505 Forrester Dr Se, Dawson, Georgia. You can reach out to her office (for appointments etc.) via phone at
(229) 405-6249.
Dr Hailey Long is licensed to practice in Georgia (license number OPT003689) and she also participates in the medicare program. She does not accept medicare assignments directly but she may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. Her NPI Number is 1407623424.
Healthcare Provider's Profile
| Full Name | Dr Hailey Long |
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| Gender | Female |
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| Speciality | Optometrist |
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| Location | 505 Forrester Dr Se, Dawson, Georgia |
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| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
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NPI Data:
- NPI Number: 1407623424
- Provider Enumeration Date: 12/11/2023
- Last Update Date: 09/26/2025
Medicare PECOS Information:
- PECOS PAC ID: 5395186431
- Enrollment ID: I20240507003578
Medical Identifiers
Medical identifiers for Dr Hailey Long such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1407623424 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
|---|
| 152W00000X | Optometrist | 3033-IOD (West Virginia) | Secondary |
| 152W00000X | Optometrist | OPT003689 (Georgia) | Primary |
Medicare Reassignments
Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Medicare reassignment of benefits is a mechanism by which practitioners allow third parties to bill and receive payment for medicare services performed by them. Dr Hailey Long allows following entities to bill medicare on her behalf.
| Provider Name | Fairmont Eye Care Inc |
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| Provider Type | Part B Supplier - Clinic/group Practice |
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| Provider Identifiers | NPI Number: 1104889971
PECOS PAC ID: 7618093295
Enrollment ID: O20111213000004 |
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Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Dr Hailey Long is
enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
| Mailing Address | Practice Location Address |
|---|
Dr Hailey Long, OD
505 Forrester Dr Se,
Dawson, GA 39842-2006
Ph: (229) 405-6249 | Dr Hailey Long, OD
505 Forrester Dr Se,
Dawson, GA 39842-2006
Ph: (229) 405-6249 |
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