MEDICARE: DR. DEREK SCOTT LONG O.D.

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	152W00000X	Optometrist	AR2547	AR

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1699734368
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. DEREK SCOTT LONG O.D.

Provider Business Mailing Address
First Line	:	115 AUDUBON DR
Second Line	:	SUITE 8
City	:	MAUMELLE
State	:	AR
Zip	:	72113-7408
Country	:	US
Telephone Number	:	501-803-3937
Fax Number	:	501-803-3962

Provider Business Practice Location Address
First Line	:	115 AUDUBON DR
Second Line	:	SUITE 8
City	:	MAUMELLE
State	:	AR
Zip	:	72113-7408
Country	:	US
Telephone Number	:	501-803-3937
Fax Number	:	501-803-3962

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

Provider Enumeration Date	:	03/21/2006
Last Update Date	:	05/24/2010

Similar Medicare Providers

1780067587 — ANDREA WALKER
Practice Location Address:

115 AUDUBON DR
MAUMELLE, AR
72113-7408

Practice Phone: 501-803-3937
Practice Fax:

1063415800 — UNITED METHODIST BEHAVIORAL HEALTH SYSTEM, INC
Practice Location Address:

1601 MURPHY DRIVE
MAUMELLE, AR
72113

Practice Phone: 501-803-3388
Practice Fax: 501-803-4272

1679571863 — TRACY THOMAS PHILLIPS D.O.
Practice Location Address:

2001 CLUB MANOR DR STE S
MAUMELLE, AR
72113-7417

Practice Phone: 501-734-8085
Practice Fax: 501-734-8088

1588658629 — DR. THOMAS STUART HARRIS M.D.
Practice Location Address:

38 MASTERS PLACE DR
MAUMELLE, AR
72113-7019

Practice Phone: 501-295-3236
Practice Fax: 501-295-3236

1730163072 — MAUMELLE PHYSICAL THERAPY
Practice Location Address:

9843 MAUMELLE BLVD
NORTH LITTLE ROCK, AR
72113-7027

Practice Phone: 501-851-6600
Practice Fax: 501-851-6643

1114901451 — KENNY A DE LUCA P.T.
Practice Location Address:

9843 MAUMELLE BLVD
NORTH LITTLE ROCK, AR
72113-7027

Practice Phone: 501-753-2201
Practice Fax: 501-753-2207

Directions to “ DR. DEREK SCOTT LONG O.D.” 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.