MEDICARE: TRAVIS KYLE LONG ATC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	2255A2300X	Athletic Trainer	608	OK

General Provider Information

NPI Number	:	1235421256
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	TRAVIS KYLE LONG ATC

Provider Business Mailing Address
First Line	:	1110 N LEE AVE
Second Line	:
City	:	OKLAHOMA CITY
State	:	OK
Zip	:	73103-2612
Country	:	US
Telephone Number	:	405-230-9000
Fax Number	:	405-230-9175

Provider Business Practice Location Address
First Line	:	4901 W RENO AVE
Second Line	:	STE 500
City	:	OKLAHOMA CITY
State	:	OK
Zip	:	73127-6346
Country	:	US
Telephone Number	:	405-230-9290
Fax Number	:	405-230-9284

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/10/2011
Last Update Date	:	05/10/2011

Similar Medicare Providers

1841298981 — KRISTINE COX PT
Practice Location Address:

4901 W RENO AVE , SUITE 500
OKLAHOMA CITY, OK
73127-6346

Practice Phone: 405-230-9250
Practice Fax: 405-943-0747

1891793857 — JOEL SCOT STEELE PA
Practice Location Address:

4901 W RENO AVE , STE 500
OKLAHOMA CITY, OK
73127-6346

Practice Phone: 405-230-9250
Practice Fax: 405-943-0742

1073512711 — DR. RANDEL DEAN ESTEP DO
Practice Location Address:

4901 W RENO AVE , STE 500
OKLAHOMA CITY, OK
73127-6346

Practice Phone: 405-230-9250
Practice Fax: 405-943-0742

1770531329 — JAMES SHIPPEY JONES PT
Practice Location Address:

4901 W RENO AVE
OKLAHOMA CITY, OK
73127-6346

Practice Phone: 405-230-9290
Practice Fax: 405-943-0742

1346297983 — ACCREDO HEALTH GROUP INC
Practice Location Address:

4901 W RENO , STE 950
OKLAHOMA CITY, OK
73127-6346

Practice Phone: 405-942-3961
Practice Fax: 405-949-2689

1720015241 — BERNADETTE MARIE DUBE PA
Practice Location Address:

4901 W RENO AVE
OKLAHOMA CITY, OK
73127-6346

Practice Phone: 405-230-9250
Practice Fax: 405-943-0742

Directions to “ TRAVIS KYLE LONG ATC” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.