Individual
DR. DEREK SCOTT LONG
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
O.D.
Contact information
Practice address
115 AUDUBON DR, SUITE 8, MAUMELLE, AR 72113-7408
(501) 803-3937
(501) 803-3962
Mailing address
115 AUDUBON DR, SUITE 8, MAUMELLE, AR 72113-7408
(501) 803-3937
(501) 803-3962
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
AR2547
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
154833722
—
AR
Enumeration date
03/21/2006
Last updated
05/24/2010
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