Long, Jeffrey Michael
Long, Jeffrey Michael is an individual health care provider with primary practice located at 7374 S. Olympia Ave. , Tulsa OK 74132-1849. He recently has 3 registered licenses in different health care specialties including Eye and Vision Services Providers / Optometrist, Eye and Vision Services Providers / Corneal and Contact Management, Eye and Vision Services Providers / Pediatrics. Eye and Vision Services Providers / Optometrist is his primary health care specialty. Long, Jeffrey Michael can be contacted via phone (918) 794-2020.Contact Information
Primary practice address
7374 S. Olympia Ave.
Tulsa OK 74132-1849
Phone: (918) 794-2020
Fax: (918) 794-2720
Website:
Health care specialties
Specialty | Code | License # | State |
---|---|---|---|
Eye and Vision Services Providers / Optometrist | 152W00000X | 2341 | Oklahoma |
Eye and Vision Services Providers / Corneal and Contact Management | 152WC0802X | 2341 | Oklahoma |
Eye and Vision Services Providers / Pediatrics | 152WP0200X | 2341 | Oklahoma |
Profile Details
NPI number | 1770602302 |
---|---|
LBN Legal business name | Long, Jeffrey Michael |
Credentials | Doctor of Optometry (OD) |
Entity | Individual |
Sole proprietor 1 | No |
Enumeration date | Mar 28th, 2007 |
Last updated | Oct 12th, 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 | 1770602302 | NPPES |
Oklahoma | MEDICAID | 200427010A | |
Oklahoma | MEDICAID | 100762220A |
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