Individual
DR. JOHN WONG
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1255 HILYARD ST, EUGENE, OR 97401-3718
(503) 686-7300
Mailing address
PO BOX 4078, PORTLAND, OR 97208-4078
(888) 633-0086
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
MD20273
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
057221011
BCBS
—
05
—
085589
—
OR
01
—
111343
WASHINGTON L&I
—
05
—
8280141
—
WA
01
—
A023
CHAMPUS
—
01
—
G42233
GROUP HEALTH
—
05
—
XPY188770
—
CA
Enumeration date
06/06/2006
Last updated
12/15/2021
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