Individual
TONY WONG LEUNG
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
105 S RYAN ST, LAKE CHARLES, LA 70601-5950
(337) 497-0366
(337) 497-1367
Mailing address
PO BOX 6574, LAKE CHARLES, LA 70606-6574
(337) 497-0366
(337) 497-1367
Taxonomy
Speciality
Code
Description
License number
State
207RN0300X
Nephrology Physician
Primary
07961R
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1386812
—
LA
Enumeration date
07/18/2005
Last updated
12/05/2011
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