Dr Jerry W Long Optometry

NPI #1073719910 in Poplar Bluff, Missouri

Provider Information

NPI Number: 1073719910
Entity Type: Organization
Organization Name: Dr Jerry W Long Optometry
Primary Specialty: Optometrist
Enumeration Date: Jun 26, 2007
Last Updated: Jan 8, 2015

Practice Location

Address: 213 N BROADWAY ST
City: Poplar Bluff
State: Missouri
ZIP Code: 63901-5135
Phone: (573) 785-8476

Authorized Official

Name: DR. JERRY WAYNE LONG, OD
Title: OWNER OPTOMOTRIST
Phone: (573) 785-8476

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Optometrist	152W00000X	Primary

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