Individual
JUSTIN CARMINE WONG
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
2902 W AGUA FRIA FWY STE 1090, PHOENIX, AZ 85027-3970
(602) 648-5444
(602) 772-3801
Mailing address
PO BOX 80217, PHOENIX, AZ 85060-0217
(602) 385-2115
(480) 418-3323
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
52139
AZ
207XS0106X
Orthopaedic Hand Surgery Physician
Primary
52139
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
152319
—
AZ
Enumeration date
04/29/2009
Last updated
07/26/2022
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