Individual
DR. GARY WILLIAM BONG
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
6071 E WOODMEN RD, SUITE 300, COLORADO SPRINGS, CO 80923-2607
(719) 531-7007
(719) 531-7122
Mailing address
6071 E WOODMEN RD, SUITE 300, COLORADO SPRINGS, CO 80923-2607
(719) 531-7007
(719) 531-7122
Taxonomy
Speciality
Code
Description
License number
State
208800000X
Urology Physician
Primary
47336
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
19852843
—
CO
Enumeration date
10/17/2006
Last updated
05/04/2021
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