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Individual

BENJAMIN ANDREW LONG

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man

Contact information

Practice address
1108 N WHEELER AVE, SALLISAW, OK 74955-2227
(918) 774-5513
(918) 775-5526
Mailing address
4103 S YALE AVE STE B, TULSA, OK 74135-6002

Taxonomy

Speciality
Code
Description
License number
State
175T00000X
Peer Specialist
Primary
OK

Other

Enumeration date
12/29/2025
Last updated
12/29/2025
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