Organization
DEREK S LONG OD INC
Active
Other names
North Little Rock Primary Eye Care
Organization subpart
No
Provider details
NPI number
Authorized official
DEREK S LONG O.D. (DOCTOR)
(501) 803-3937
Entity
Organization
Contact information
Practice address
406 W PERSHING BLVD, NORTH LITTLE ROCK, AR 72114-2146
(501) 753-3145
(501) 753-1806
Mailing address
406 W PERSHING BLVD, NORTH LITTLE ROCK, AR 72114-2146
(501) 753-3145
(501) 753-1806
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
2547
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1487812392
—
AR
Enumeration date
12/17/2008
Last updated
05/31/2011
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