KENNETH EDWARD WONG


Address: 102 Twin Oaks Dr, Raceland, LA 70394-2760
Phone: 9858374000

KENNETH EDWARD WONG (NPI# 1215935986) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1215935986
Entity Type Individual
Full Name KENNETH EDWARD WONG
Credential MD
Practice Address 102 Twin Oaks Dr
Raceland
LA 70394-2760
Mailing Address Po Box 4176
Houma
LA 70361-4176
Practice Telephone 9858374000
Practice Fax Number 9855374074
Mailing Telephone 9858760300
Mailing Fax Number 9858720317
Enumeration Date 2005-07-07
Last Update Date 2015-10-19
Gender Code M
Is Sole Proprietor N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 207RC0000X Internal Medicine
Specialization: Cardiovascular Disease
11066R LA Allopathic & Osteopathic Physicians

Other Provider Identifier

State Issuer Identifier Type Code
LA RR MEDICARE 060048455 01
LA 1663522 05

Other Providers KENNETH WONG

NPI Name Taxonomy Address Enumeration
1992153977 Kenneth Wong Physician Assistant 622 W 168th St # Vc-260, New York, NY 10032-3720 2016-05-31
1669826285 Kenneth Richard Wong Emergency Medicine 525 East 68th Street, Mailbox 301, Ny Presbyterian Cornell- Emergency Medicine Residency, New York City, NY 10021 2016-04-20
1497988232 Kenneth D Wong Dentist 13197 Central Ave Ste 103, Chino, CA 91710-4178 2009-08-27
1073775433 Kenneth Wong Otolaryngology 6201 Greenbelt Rd Ste M11, Berwyn Heights, MD 20740-2333 2008-06-26
1033391925 Kenneth L Wong Pharmacist 221 Westwood Plaza Room 222, Los Angeles, CA 90095-0001 2007-12-03
1104995307 Kenneth C K Wong Dentist 6514 Lonetree Blvd, Rocklin, CA 95765 2006-11-06
1427154715 Kenneth Wong Pharmacist 11201 Benton St. (119), Loma Linda, CA 92357 2006-09-15
1235198854 Kenneth Kang Wa Wong Optometrist 27118 Gratiot Ave, Roseville, MI 48066-2915 2006-03-22
1417949652 Kenneth Wong Family Medicine 2444 Pine St, Bakersfield, CA 93301-2742 2005-08-15
1033680285 Kenneth Wong Pharmacist 3160 N Rainbow Blvd, Las Vegas, NV 89108-4533 2018-12-16

Office Location

Street Address 102 TWIN OAKS DR
City RACELAND
State LA
Zip Code 70394-2760

Providers in the same location

NPI Name Taxonomy Address Enumeration
1497109979 Murray Joseph Morella Nurse Practitioner 102 Twin Oaks Dr, Raceland, LA 70394-2760 2016-04-20

Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1598221798 Caitlin Morris Bacon Registered Nurse 4244 Highway 1, Raceland, LA 70394 2019-02-13
1326571597 Kakeisha Harris Counselor 144 Colvan St, Raceland, LA 70394 2017-04-05
1023468774 Denise Taylor Counselor 4075 Hwy 1, Raceland, LA 70394 2016-06-14
1023471133 Aubrey Orgeron Psychiatry & Neurology 111 Twin Oaks Dr., Raceland, LA 70394 2016-04-05
1114383239 Michelle Rabb Counselor 3821 Hwy 1, Raceland, LA 70394 2016-01-05
1508221979 Renisha Cecilia Oubre Counselor 3821 Highway 1, Raceland, LA 70394 2015-12-29
1922463983 Kiaria Gray Case Manager/Care Coordinator 3821 La-1, Raceland, LA 70394 2015-12-17
1285068098 Don A Falgout Nurse Anesthetist, Certified Registered 4608 Hwy 1, Raceland, LA 70394 2013-08-28
1215211933 Dalton Joseph Boudreaux Jr. Pharmacist 4572 Hwy One, Raceland, LA 70394 2011-09-29
1790065746 Cheri Lasseigne Chiropractor 108 Acadia Dr., Raceland, LA 70394 2011-08-23
Find all providers in zip 70394

Taxonomy Information

Taxonomy Code 207RC0000X
Grouping Allopathic & Osteopathic Physicians
Classification Internal Medicine
Specialization Cardiovascular Disease

Taxonomy Definition

An internist who specializes in diseases of the heart and blood vessels and manages complex cardiac conditions such as heart attacks and life-threatening, abnormal heartbeat rhythms.
Notes: Source: American Osteopathic Board of Internal Medicine, 2008 [7/1/2008: added definition, added source; 7/1/2011: modified source]
- Additional Resources: American Board of Internal Medicine, http://www.abim.org/. American Osteopathic Board of Internal Medicine, https://www.osteopathic.org/certification
- Board certification for Medical Doctors (MDs) is provided by the American Board of Internal Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Internal Medicine.

Providers in the same taxonomy and state

NPI Name Taxonomy Address Enumeration
1902424583 Ochsner Clinic LLC Internal Medicine 64040 Highway 434 Ste 100, Lacombe, LA 70445-3499 2020-07-09
1336776038 Louisiana Community Health Center Internal Medicine 91 Westbank Expy Ste 440, Gretna, LA 70053-3678 2020-03-24
1902443310 Affinity Health Gorup, LLC Internal Medicine 2516 Broadmoor Blvd Ste 2, Monroe, LA 71201-2988 2019-12-04
1487296588 Imperial Health LLP Internal Medicine 200 W 5th Street, Deridder, LA 70634 2019-10-10
1235789595 Cardiovascular Specialty Care Center - Vascular Internal Medicine 7777 Hennessy Blvd Ste 215, Baton Rouge, LA 70808-4365 2019-09-18
1184140154 Cardiovascular Specialty Care Center of Covington, LLC Internal Medicine 71070 Highway 21, Covington, LA 70433-7160 2017-08-21
1508388299 Louisiana State University School of Medicine In New Orleans Faculty G Internal Medicine 120 Ochsner Blvd Ste 340, Gretna, LA 70056-5249 2017-07-13
1003348012 Vascular Advantages of La, LLC Internal Medicine 10966 Laird Ln, Denham Springs, LA 70726-7963 2017-03-29
1104281476 White Clover, LLC Internal Medicine 8835 Line Ave Ste 400, Shreveport, LA 71106-6730 2015-12-30
1538543574 Prevail Heart Clinic of Ville Platte, LLC Internal Medicine 504 Jack Miller Rd Ste 8, Ville Platte, LA 70586-5600 2015-07-18
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Competitor

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City RACELAND
Zip Code 70394

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Dataset Information

Data Provider Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES)
Jurisdiction Medicare & Medicaid

This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.

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