NPI 1144295197

Jerry Wayne Long, OD

Practitioner Optometrist Poplar Bluff, MO

Practice location

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

Registered specialties

Optometrist Primary

Eye and Vision Services Providers Taxonomy 152W00000X Licence T02229 (MO)

Other Optometrist providers in Missouri →

Registry record

NPI: 1144295197
Entity type: Individual
Sex (as registered): Male
NPI issued: 22 Feb 2006
Record last updated: 3 Jul 2014

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.