Individual
JING DONG
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD PHD
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
045447
GA
207WX0009X
Glaucoma Specialist (Ophthalmology) Physician
045447
GA
207WX0200X
Ophthalmic Plastic and Reconstructive Surgery Physician
045447
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
$$$$$$$$$
TRICARE
GA
05
—
00791568B
—
GA
01
—
101703
AVESIS
GA
01
—
2790413
CIGNA
GA
01
—
343319
WELLCARE
GA
01
—
5983746
AETNA
GA
01
—
787526
BLUE CROSS BLUE SHIELD
GA
01
—
GRP7640
MEDICARE
GA
Enumeration date
07/22/2005
Last updated
02/28/2023
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