Individual
DR. CHARLES W WONG
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
310 S MAIN ST, HARTFORD, KY 42347-1129
(270) 298-9136
(270) 298-9039
Mailing address
310 S MAIN ST, PO BOX 148, HARTFORD, KY 42347-1129
(270) 298-9136
(270) 298-9039
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
2041
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1D65909921
—
KY
Enumeration date
10/19/2005
Last updated
01/09/2010
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