Organization
VICTOR D LONG CRNA MS INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
VICTOR D LONG CRNA MS (PRESIDENT)
(405) 364-6182
Entity
Organization
Contact information
Practice address
415 W GRAY ST, NORMAN, OK 73069-7117
(405) 364-6182
(405) 364-5379
Mailing address
415 W GRAY ST, NORMAN, OK 73069-7117
(405) 364-6182
(405) 364-5379
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
R0033797
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100785020B
—
OK
01
—
430067242
RR MEDICARE PIN
OK
Enumeration date
07/06/2006
Last updated
08/19/2008
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