Organization Name: | JAMES A. LONG, II O.D. INC |
NPI Number: | 1871726562 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | JAMES A LONG (OPTOMETRIST) |
Mailing Address: | 1221 Medical Park Dr Fort Wayne |
State: | IN US |
Postal Code: | 468255887 |
Phone Number: | 2604842720 |
Fax Number: | 2604713488 |
NPI Enumeration Date: | 08/27/2009 |
NPI Last Update Date: | 08/27/2009 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 332H00000X |
License Number: | 18001507 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | IN |
Taxonomy Type: | Suppliers |
Taxonomy Classification: | Eyewear Supplier (Equipment, not the service) |
Taxonomy Specialization: | |
Taxonomy Definition: | An organization that provides spectacles, contact lenses, and other vision enhancement devices prescribed by an optometrist or ophthalmologist. |