Organization
JAMES W LONG MD PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. KAREN D WALLS (OFFICE MANAGER)
(503) 581-7412
Entity
Organization
Contact information
Practice address
1020 LIBERTY ST SE, SALEM, OR 97302-4141
(503) 581-7412
(503) 581-1095
Mailing address
1020 LIBERTY ST SE, SALEM, OR 97302-4141
(503) 581-7412
(503) 581-1095
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
1604AT
OR
152W00000X
Optometrist
3152ATI
OR
207W00000X
Ophthalmology Physician
Primary
MD10954
OR
207W00000X
Ophthalmology Physician
MD26362
OR
332H00000X
Eyewear Supplier
MD10954
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
241802
—
OR
Enumeration date
04/17/2007
Last updated
10/27/2007
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