Individual
JACQLYN E LONG
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
O.D.
Contact information
Practice address
211 E BROADWAY, ALTON, IL 62002-6220
(618) 462-9818
(314) 741-4947
Mailing address
8885 LADUE RD, SAINT LOUIS, MO 63124-2088
(314) 721-2720
(314) 725-2685
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
046-008207
IL
152W00000X
Optometrist
T02865
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0854830001
DMERC
—
05
—
318096041
—
MO
Enumeration date
12/13/2006
Last updated
02/20/2015
About Stedi
Stedi is the only programmable healthcare clearinghouse. You can use Stedi's APIs to process eligibility checks, claims, remits, and more.
Contact us