Individual
DR. JEFFREY MICHAEL LONG
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
OD
Contact information
Practice address
7374 S. OLYMPIA AVE., TULSA, OK 74132-1849
(918) 794-2020
(918) 794-2720
Mailing address
7374 S. OLYMPIA AVE., TULSA, OK 74132-1849
(918) 794-2020
(918) 794-2720
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
2341
OK
152WC0802X
Corneal and Contact Management Optometrist
2341
OK
152WP0200X
Pediatric Optometrist
2341
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100762220A
—
OK
05
—
200427010A
—
OK
Enumeration date
03/28/2007
Last updated
10/12/2012
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