Provider Demographics
NPI:1720215064
Name:LONG, JOHN STEVEN JR (MD)
Entity Type:Individual
Prefix:DR
First Name:JOHN
Middle Name:STEVEN
Last Name:LONG
Suffix:JR
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:608 NW 9TH ST
Mailing Address - Street 2:SUITE 1100
Mailing Address - City:OKLAHOMA CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73102-1068
Mailing Address - Country:US
Mailing Address - Phone:405-231-3000
Mailing Address - Fax:405-231-3073
Practice Address - Street 1:2150 S DOUGLAS BLVD STE A
Practice Address - Street 2:
Practice Address - City:MIDWEST CITY
Practice Address - State:OK
Practice Address - Zip Code:73130-6200
Practice Address - Country:US
Practice Address - Phone:405-476-7040
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-06-13
Last Update Date:2023-07-15
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
OK26483207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine