Individual
MR. DAVID A LONG II
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
700 S TELEPHONE ROAD, MOORE, OK 73160
(405) 793-9355
Mailing address
6604 AVONDALE DR, NICHOLS HILLS, OK 73116-6018
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
20241
OK
207PE0004X
Emergency Medical Services (Emergency Medicine) Physician
Primary
20241
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100131980B
—
OK
Enumeration date
05/01/2006
Last updated
05/24/2010
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