Jerry Wayne Long in Poplar Bluff - Optometrist
Jerry Wayne Long - NPI 1144295197
Jerry Wayne Long is a Optometrist in Poplar Bluff, Missouri. Jerry Wayne Long practices all healthcare services and medical treatments related to Optometrist. The NPI Number for Jerry Wayne Long is 1144295197. The last update date is 2014-07-03.
Jerry Wayne Long's current location address is 213 N Broadway St, Poplar Bluff, Missouri. You can contact this provider via phone number 5737858476. The mailing address for Jerry Wayne Long is 213 N Broadway St, Poplar Bluff, Missouri. To know further, please read the information below!
Provider Profile Detail
| Provider Name | Jerry Wayne Long |
|---|---|
| Address | 213 N Broadway St, Poplar Bluff, Missouri |
| Phone Number | 5737858476 |
| Fax Number | |
| Sole Proprietor | Y |
| Credentials | O.D |
NPI Number Detail
| NPI Number | 1144295197 |
|---|---|
| Provider Enumeration Date | 2006-02-22 |
| Last Updated Date | 2014-07-03 |
Provider Mailing Address Detail
| Address | 213 N Broadway St |
|---|---|
| City | Poplar Bluff |
| State | Missouri (MO) |
| Post Code | 639015135 |
| Phone Number | 5737858476 |
| Fax Number |
Provider's Primary Taxonomy Detail
| Speciality | Optometrist |
|---|---|
| Taxonomy | 152W00000X |
| Licence No | T02229 |
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Definition: Doctors of optometry (ODs) are the primary health care professionals for the eye. Optometrists examine, diagnose, treat, and manage diseases, injuries, and disorders of the visual system, the eye, and associated structures as well as identify related |
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Provider's Other Legacy Identifiers
| Identifier | Identifier Type | Identifier State | Identifier Issuer |
|---|---|---|---|
| 310038807 | MO | -- | |
| 6948 | MO | MEDICARE P-TAN | |
| 500398706 | MO | -- | |
| 990001270 | MO | GROUP NUMBER |
Post Comment/ Review Below
What is the unique 10-digit identification code issued to Jerry Wayne Long by the Centers for Medicare & Medicaid Services?
The Jerry Wayne Long has been assigned the NPI (National Provider Identifier) 1144295197 by the Centers for Medicare & Medicaid Services (CMS). This 10-digit code serves as a unique identifier for healthcare providers.
Could you please provide the complete physical location address of Jerry Wayne Long?
The Jerry Wayne Long is physically situated at 213 N Broadway St, in the city of Poplar Bluff, state of MO, with the postal code 639015135.
What is Jerry Wayne Long's primary field of medical specialization, and what is the corresponding taxonomy classification code for this area of expertise?
The primary field of medical specialization for Jerry Wayne Long is Optometrist, and the taxonomy classification code that categorizes this area of expertise is 152W00000X.
On what date did the Centers for Medicare & Medicaid Services originally issue the 1144295197 to Jerry Wayne Long?
The Centers for Medicare & Medicaid Services originally issued the 1144295197 to Jerry Wayne Long on 2006-02-22.
As of what date were the Jerry Wayne Long's details last updated?
The information pertaining to the Jerry Wayne Long, including its address, specialty, and other details, was most recently updated on 2014-07-03.