Individual
VIVIAN C ONG
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
223 RIVER DR, IRVINE, KY 40336-1142
(606) 723-5142
(606) 723-3798
Mailing address
PO BOX 908, IRVINE, KY 40336-0908
(606) 723-5142
(606) 723-3798
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
32891
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
64328917
—
KY
Enumeration date
06/28/2005
Last updated
02/03/2011
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