Individual
ERIC LONG
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
4401 S WESTERN AVE, OKLAHOMA CITY, OK 73109-3413
(405) 636-7000
Mailing address
PO BOX 891661, OKLAHOMA CITY, OK 73189-1661
(918) 200-9450
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
4210
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200031890A
—
OK
Enumeration date
04/04/2006
Last updated
08/23/2019
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