Provider Demographics
NPI:1205194305
Name:DAVID WONG SPINE PC
Entity Type:Organization
Organization Name:DAVID WONG SPINE PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PHYSICIAN
Authorized Official - Prefix:
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:A
Authorized Official - Last Name:WONG
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:303-697-7463
Mailing Address - Street 1:7800 E ORCHARD RD
Mailing Address - Street 2:SUITE 100
Mailing Address - City:GREENWOOD VILLAGE
Mailing Address - State:CO
Mailing Address - Zip Code:80111-2583
Mailing Address - Country:US
Mailing Address - Phone:303-697-7463
Mailing Address - Fax:303-783-1200
Practice Address - Street 1:7800 E ORCHARD RD
Practice Address - Street 2:SUITE 100
Practice Address - City:GREENWOOD VILLAGE
Practice Address - State:CO
Practice Address - Zip Code:80111-2583
Practice Address - Country:US
Practice Address - Phone:303-697-7463
Practice Address - Fax:303-783-1200
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-04-25
Last Update Date:2012-08-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207XS0117XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryOrthopaedic Surgery of the SpineGroup - Single Specialty