Healthcare Provider Details

I. General information

NPI: 1346409745
Provider Name (Legal Business Name): FRANCIS D ONG MD PA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/02/2008
Last Update Date: 06/02/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1895 KINGSLEY AVE SUITE 403
ORANGE PARK FL
32073-4466
US

IV. Provider business mailing address

1895 KINGSLEY AVE SUITE 403
ORANGE PARK FL
32073-4466
US

V. Phone/Fax

Practice location:
  • Phone: 904-213-9005
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208200000X
TaxonomyPlastic Surgery Physician
License NumberME50427
License Number StateZZ

VIII. Authorized Official

Name: FRANCIS D ONG
Title or Position: OWNER
Credential: MD
Phone: 904-421-2119