Individual
DR. BRUNSWICK ROYALTON WONG
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
O.D.
Contact information
Practice address
411 FAIRVIEW AVE, GREENVILLE, MS 38701-4816
(662) 332-7229
(662) 378-3949
Mailing address
411 FAIRVIEW AVE, GREENVILLE, MS 38701-4816
(662) 332-7229
(662) 378-3949
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
452
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
09539294
—
MS
Enumeration date
10/03/2006
Last updated
02/05/2008
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