Individual
DR. TIE S. ONG
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
700 W GROVE ST, EL DORADO, AR 71730-4416
(870) 862-1577
Mailing address
611 THOMPSON AVE, P.O. BOX 506, EL DORADO, AR 71730-4557
(870) 862-1577
(870) 862-5916
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
R3031
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
5C070
GRP.'S MCARE PROV.#
AR
01
—
R3031
ST. MED.LICENSE #
AR
Enumeration date
08/23/2006
Last updated
10/15/2007
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