Individual
BRIAN KENNETH WONG
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
969 FRAYSER BLVD, MEMPHIS, TN 38127-5977
(901) 842-3162
(901) 842-2362
Mailing address
4417 N 6TH ST, PHILADELPHIA, PA 19140-2319
(215) 302-3600
(901) 260-8590
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
56026
TN
207R00000X
Internal Medicine Physician
Primary
MD481351
PA
208000000X
Pediatrics Physician
56026
TN
208000000X
Pediatrics Physician
MD481351
PA
Other
Enumeration date
04/16/2014
Last updated
07/29/2023
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