Provider Demographics
NPI:1144270042
Name:WONG, WILLIAM K JR (MD)
Entity type:Individual
Prefix:
First Name:WILLIAM
Middle Name:K
Last Name:WONG
Suffix:JR
Gender:M
Credentials:MD
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Mailing Address - Street 1:99-128 AIEA HEIGHTS DR
Mailing Address - Street 2:SUITE 703
Mailing Address - City:AIEA
Mailing Address - State:HI
Mailing Address - Zip Code:96701-3925
Mailing Address - Country:US
Mailing Address - Phone:808-487-7938
Mailing Address - Fax:808-485-8022
Practice Address - Street 1:99-128 AIEA HEIGHTS DR
Practice Address - Street 2:SUITE 703
Practice Address - City:AIEA
Practice Address - State:HI
Practice Address - Zip Code:96701-3925
Practice Address - Country:US
Practice Address - Phone:808-487-7938
Practice Address - Fax:808-485-8022
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-11
Last Update Date:2010-09-30
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Provider Licenses
StateLicense IDTaxonomies
HIMD-10426207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
HI576027Medicaid
HI576027Medicaid
HII31612Medicare UPIN
HI5713610001Medicare NSC