Healthcare Provider Details

I. General information

NPI: 1114989233
Provider Name (Legal Business Name): SUZANNE WONG YEE MD
Entity Type: Individual
Gender: Female
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 04/04/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11811 HINSON RD
LITTLE ROCK AR
72212
US

IV. Provider business mailing address

11811 HINSON
LITTLE ROCK AR
72212
US

V. Phone/Fax

Practice location:
  • Phone: 501-224-1044
  • Fax: 501-224-0447
Mailing address:
  • Phone: 501-224-1044
  • Fax: 501-224-0447

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2086S0122X
TaxonomyPlastic and Reconstructive Surgery Physician
License NumberC7769
License Number StateAR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: