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Organization

HENRY M KWONG, M.D. A PROF MED CORP

Active
Parent organization
HENRY M. KWONG, M.D. A PROF MEDICAL CORP
Organization subpart
Yes

Provider details

NPI number
Legal business name
HENRY M. KWONG, M.D. A PROF MEDICAL CORP
Authorized official
HENRY MARK KWONG, M.D. SR. M.D. (PRESIDENT)
(337) 367-1247
Entity
Organization

Contact information

Practice address
607 RUE DE BRILLE, NEW IBERIA, LA 70563
(337) 367-1247
(337) 365-7496
Mailing address
607 RUE DE BRILLE, NEW IBERIA, LA 70563
(337) 367-1247
(337) 365-7496

Taxonomy

Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
012632
LA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1197980
LA
Enumeration date
12/03/2009
Last updated
12/03/2009
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