Provider Demographics
NPI:1881778009
Name:HONG, JAMES (DPM)
Entity type:Individual
Prefix:DR
First Name:JAMES
Middle Name:
Last Name:HONG
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9001 BROADWAY
Mailing Address - Street 2:
Mailing Address - City:MERRILLVILLE
Mailing Address - State:IN
Mailing Address - Zip Code:46410-7039
Mailing Address - Country:US
Mailing Address - Phone:219-795-3360
Mailing Address - Fax:219-756-6500
Practice Address - Street 1:9001 BROADWAY
Practice Address - Street 2:
Practice Address - City:MERRILLVILLE
Practice Address - State:IN
Practice Address - Zip Code:46410-7039
Practice Address - Country:US
Practice Address - Phone:219-795-3360
Practice Address - Fax:219-756-6500
Is Sole Proprietor?:No
Enumeration Date:2006-10-24
Last Update Date:2019-04-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL016-005245213ES0103X
IN07001044A213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN189330DMedicare PIN
ILP00470744Medicare PIN
ILK38980Medicare PIN
IN189340DMedicare PIN