Individual
FENG-MING PHOENIX KONG
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
1120 15TH ST, AUGUSTA, GA 30912-0004
(706) 724-6100
(706) 724-1600
Mailing address
1499 WALTON WAY, SUITE 1400, AUGUSTA, GA 30901-2603
(706) 724-6100
Taxonomy
Speciality
Code
Description
License number
State
2085R0001X
Radiation Oncology Physician
Primary
070150
GA
2085R0001X
Radiation Oncology Physician
4301082609
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
202I922014
PTAN
GA
Enumeration date
09/29/2006
Last updated
10/28/2014
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