Derek S Long Od, INC

NPI #1043412067 in Maumelle, Arkansas

Provider Information

NPI Number: 1043412067
Entity Type: Organization
Organization Name: Derek S Long Od, INC
Primary Specialty: Optometrist
Enumeration Date: Jun 1, 2007
Last Updated: May 24, 2010

Practice Location

Address: 115 AUDUBON DR STE 8
City: Maumelle
State: Arkansas
ZIP Code: 72113-7409
Phone: (501) 803-3937

Authorized Official

Name: DR. DEREK S LONG, O.D.
Title: DOCTOR
Phone: (501) 803-3937

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Optometrist	152W00000X	Primary

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