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:
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Health care specialties

SpecialtyCodeLicense #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 13 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1770602302 NPPES
Oklahoma MEDICAID 200427010A
Oklahoma MEDICAID 100762220A

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