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NPI Code Detail

MEDICARE: JORGE A WONG MD

MEDICARE: JORGE A WONG MD
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
12085R0001XRadiation Oncology Physician0424770KS

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
10424770OTHERKSKS LICENSE
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
4MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1083678494
Entity Type Code : Individual
Provider Name (Legal Business Name) : JORGE A WONG MD
Provider Business Mailing Address
First Line : PO BOX 256
Second Line :
City : SALINA
State : KS
Zip : 67402-0256
Country : US
Telephone Number : 785-823-0633
Fax Number : 785-823-0658
Provider Business Practice Location Address
First Line : 730 MEDICAL CENTER DR
Second Line :
City : NEWTON
State : KS
Zip : 67114-8778
Country : US
Telephone Number : 316-283-1141
Fax Number : 316-283-1162
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/13/2006
Last Update Date : 03/07/2023

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