Provider Demographics
NPI:1376760082
Name:TONG, FRANK SHANE JR (DO)
Entity Type:Individual
Prefix:
First Name:FRANK
Middle Name:SHANE
Last Name:TONG
Suffix:JR
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:214 SOUTH 4TH STREET
Mailing Address - Street 2:PO BOX 399
Mailing Address - City:KREMMLING
Mailing Address - State:CO
Mailing Address - Zip Code:80459
Mailing Address - Country:US
Mailing Address - Phone:970-724-3176
Mailing Address - Fax:970-724-9606
Practice Address - Street 1:214 S. 4TH ST
Practice Address - Street 2:
Practice Address - City:KREMMLING
Practice Address - State:CO
Practice Address - Zip Code:80459
Practice Address - Country:US
Practice Address - Phone:970-724-3176
Practice Address - Fax:970-724-9606
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-20
Last Update Date:2016-04-08
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
CO48059207Q00000X, 207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine