Individual
JOSEPH KENNETH WONG
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
3091 KIRBY WHITTEN RD, BARTLETT, TN 38134-2822
(901) 752-6963
(901) 751-5540
Mailing address
PO BOX 405827, ATLANTA, GA 30384-5800
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
MD20088
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
100057
BCBS, TN
TN
01
—
140950
UNITED HEALTHCARE
TN
01
—
3966193
CIGNA
TN
01
—
4104525
AETNA
TN
Enumeration date
08/30/2005
Last updated
10/25/2016
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