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General NPI Number Information
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NPI Number | 1255364857
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Entity Type | Organization
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Legal Business Name | FONG JAMES WONG,M.D,P.A
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Dates
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Enumeration Date | 07/08/2006
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Last Update Date | 10/08/2013
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Provider Practice Location Address
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Address Line | 1740 S.E 18TH STREET UNIT 801
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City | OCALA
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State | FL
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Zip | 34471-5447
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Country | US
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Telephone | 352-351-8877
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Fax | 352-351-8867
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Provider Business Mailing Address
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Address Line | 1740 S.E 18TH STREET UNIT 801
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City | OCALA
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State | FL
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Zip | 34471-5447
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Country | US
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Telephone | 352-351-8877
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Fax | 352-351-8867
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. FONG JAMES WONG
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Credential | M.D
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Telephone | 352-351-8877
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RE0101X
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Taxonomy Name | Endocrinology, Diabetes & Metabolism Physician
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License Number | ME76024
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License Number State | FL
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