Individual
MARY C. LONG
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
O.D.
Contact information
Practice address
114 N HICKORY ST, ABERDEEN, MS 39730-2648
(662) 369-2444
(662) 369-7223
Mailing address
114 N HICKORY ST, ABERDEEN, MS 39730-2648
(662) 369-2444
(662) 369-7223
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
490
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00087903
—
MS
Enumeration date
07/27/2007
Last updated
07/31/2009
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