Provider Demographics
NPI:1730316449
Name:HONG, AUGUSTINE RICHARD (MD)
Entity Type:Individual
Prefix:DR
First Name:AUGUSTINE
Middle Name:RICHARD
Last Name:HONG
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:PO BOX 60352
Mailing Address - Street 2:
Mailing Address - City:SAINT LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63160-0352
Mailing Address - Country:US
Mailing Address - Phone:314-362-3937
Mailing Address - Fax:866-505-8818
Practice Address - Street 1:450 N NEW BALLAS RD
Practice Address - Street 2:DEPT OPHTHALMOLOGY, STE 260
Practice Address - City:SAINT LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63141-6859
Practice Address - Country:US
Practice Address - Phone:314-362-3937
Practice Address - Fax:866-505-8818
Is Sole Proprietor?:No
Enumeration Date:2009-06-20
Last Update Date:2024-04-10
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MO2013009604207WX0120X, 207WX0120X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207WX0120XAllopathic & Osteopathic PhysiciansOphthalmologyCornea and External Diseases Specialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO200004142Medicaid
MO1730316449Medicaid