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Individual

MS. PAULETTE ONG

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
PA-C

Contact information

Practice address
1801 E 54TH ST, STE 100, DAVENPORT, IA 52807-7209
(563) 323-1229
(563) 323-8240
Mailing address
1801 E 54TH ST STE 100, DAVENPORT, IA 52807-7214
(563) 323-1229
(563) 323-8240

Taxonomy

Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
001272
IA
363AM0700X
Medical Physician Assistant
085001740
IL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
970024406
RAILROAD MEDICARE
IA
01
970024407
RAILROAD MEDICARE
IL
Enumeration date
02/17/2006
Last updated
04/26/2021
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