Individual
WAYNE P TONGCO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
2340 KNOB CREEK RD, SUITE 720, JOHNSON CITY, TN 37604-2100
(423) 926-6112
(423) 434-0278
Mailing address
2340 KNOB CREEK RD, SUITE 720, JOHNSON CITY, TN 37604-2100
(423) 926-6112
(423) 434-0278
Taxonomy
Speciality
Code
Description
License number
State
208800000X
Urology Physician
Primary
MD36058
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3875502
—
TN
Enumeration date
04/17/2006
Last updated
04/22/2009
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