Healthcare Provider Details

I. General information

NPI: 1780260216
Provider Name (Legal Business Name): PIPER LONG DO
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/23/2021
Last Update Date: 06/20/2026
Certification Date: 06/20/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

744 W 9TH ST
TULSA OK
74127-9907
US

IV. Provider business mailing address

13790 N 60TH WEST AVE
SKIATOOK OK
74070-6119
US

V. Phone/Fax

Practice location:
  • Phone: 918-599-1000
  • Fax:
Mailing address:
  • Phone: 918-798-2610
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2085R0202X
TaxonomyDiagnostic Radiology Physician
License Number7756
License Number StateOK

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: