| Jonathan Ray Long Md Llc | |
|
210 E Franklin Ave Weatherford OK 73096-5135 | |
| (580) 772-5600 | |
| (580) 772-5604 |
| Full Name | Jonathan Ray Long Md Llc |
|---|---|
| Speciality | Family Medicine |
| Location | 210 E Franklin Ave, Weatherford, Oklahoma |
| Authorized Official Name and Position | Jonathon Ray Long (PRESIDENT) |
| Authorized Official Contact | 5807725600 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Jonathan Ray Long Md Llc 3735 Legacy Drive Weatherford OK 73096-3309 Ph: (580) 772-5600 | Jonathan Ray Long Md Llc 210 E Franklin Ave Weatherford OK 73096-5135 Ph: (580) 772-5600 |
| NPI Number | 1225349244 |
|---|---|
| Provider Enumeration Date | 06/24/2010 |
| Last Update Date | 02/25/2019 |
| Medicare PECOS PAC ID | 9436339306 |
|---|---|
| Medicare Enrollment ID | O20110209000803 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1225349244 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
| Provider Name | Jonathon R Long |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1477758423 PECOS PAC ID: 1052591922 Enrollment ID: I20110209000856 |
| Provider Name | Mary M Hines |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1588078331 PECOS PAC ID: 0941520266 Enrollment ID: I20170725001711 |
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