Individual
DR. JEROME MYRON LONG
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1100 N COLLEGE AVE, FAYETTEVILLE, AR 72703-1944
(479) 444-5016
(479) 587-5980
Mailing address
1100 N COLLEGE AVE, FAYETTEVILLE, AR 72703-1944
(479) 444-5016
(479) 587-5980
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
16355
OK
207R00000X
Internal Medicine Physician
Primary
TL4463
WY
Other
Enumeration date
09/14/2006
Last updated
07/09/2018
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