Individual
GEORGE F WONG III
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
3982 E FORREST RIDGE LN, ROGERSVILLE, MO 65742-9293
(417) 886-8487
Mailing address
3982 E FORREST RIDGE LN, ROGERSVILLE, MO 65742-9293
(417) 886-8487
Taxonomy
Speciality
Code
Description
License number
State
2084N0400X
Neurology Physician
Primary
R7J28
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
107063
BLUE CROSS/BLUE SHIELD
—
05
—
202851200
—
MO
Enumeration date
06/17/2006
Last updated
10/18/2021
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