Dr Jerry W Long Optometry

Optometrist · Poplar Bluff, MO

Organization Active NPI

NPI number 1073719910

Practice location

213 N Broadway St
Poplar Bluff, MO 63901-5135
Phone
(573) 785-8476
Fax
(573) 785-8477

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NPI record

NPI
1073719910
Entity type
Organization (Type 2)
Enumeration date
June 26, 2007
Last updated
January 8, 2015
Organization subpart
No

Specialties & taxonomy codes

TaxonomyCodeLicenseState
Optometrist Primary 152W00000X T02229 MO

Authorized official

Name
Dr. Jerry Wayne Long, OD
Title
Owner Optomotrist
Phone
(573) 785-8476

About Dr Jerry W Long Optometry

Dr Jerry W Long Optometry is a healthcare organization registered in the NPI registry with the primary taxonomy Optometrist (code 152W00000X). The practice location is 213 N Broadway St, Poplar Bluff, MO 63901-5135. The NPI number 1073719910 was assigned on June 26, 2007 and the record was last updated on January 8, 2015.

Dr Jerry W Long Optometry lists a license in the registry: #T02229 (MO) for Optometrist. License numbers are self-reported to NPPES; verify them with the state licensing board.

The authorized official for this organization is Dr. Jerry Wayne Long, OD, Owner Optomotrist.

Frequently asked questions

What is the NPI number of Dr Jerry W Long Optometry?

The NPI number is 1073719910.

What is the phone number of Dr Jerry W Long Optometry?

The phone number listed for the practice location is (573) 785-8476.

Where is Dr Jerry W Long Optometry located?

213 N Broadway St, Poplar Bluff, MO 63901-5135.

What is the taxonomy code for Dr Jerry W Long Optometry?

The primary taxonomy code is 152W00000X – Optometrist.

Is this information correct?

All details come from the public NPPES registry. Providers can update their record at nppes.cms.hhs.gov; changes appear here after the next weekly update.

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