Dr Jerry W Long Optometry
Optometrist · Poplar Bluff, MO
Practice location
213 N Broadway StPoplar Bluff, MO 63901-5135
- Phone
- (573) 785-8476
- Fax
- (573) 785-8477
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
| Taxonomy | Code | License | State |
|---|---|---|---|
| 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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