Provider Demographics
NPI:1376665448
Name:WONG, ANTHONY K (MD)
Entity Type:Individual
Prefix:
First Name:ANTHONY
Middle Name:K
Last Name:WONG
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 30
Mailing Address - Street 2:
Mailing Address - City:STOUGHTON
Mailing Address - State:MA
Mailing Address - Zip Code:02072-0030
Mailing Address - Country:US
Mailing Address - Phone:781-344-3535
Mailing Address - Fax:508-535-0192
Practice Address - Street 1:15 ROCHE BROS. WAY
Practice Address - Street 2:ORTHOPEDIC CARE SPECIALISTS INC
Practice Address - City:NORTH EASTON
Practice Address - State:MA
Practice Address - Zip Code:02356
Practice Address - Country:US
Practice Address - Phone:781-344-3535
Practice Address - Fax:508-535-0192
Is Sole Proprietor?:No
Enumeration Date:2007-04-06
Last Update Date:2008-11-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA231105207L00000X, 208VP0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208VP0000XAllopathic & Osteopathic PhysiciansPain MedicinePain Medicine
No207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology