Brian Wong

NPI #1124474960 in Eagle, Idaho

Provider Information

NPI Number: 1124474960
Entity Type: Individual
Name: Brian Wong
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Pediatrics
Enumeration Date: May 11, 2016
Last Updated: Jun 2, 2025

Practice Location

Address: 3217 W BAVARIA ST
City: Eagle
State: Idaho
ZIP Code: 83616-5171
Phone: (208) 302-6200

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Student in an Organized Health Care Education/Training Program	390200000X
Pediatrics	208000000X	Primary

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