Wong, Randall Vernon

Wong, Randall Vernon is an sole proprietor health care provider with primary practice located at 3025 Hamaker Ct Suite 101, Fairfax VA 22031-2237. He recently has 2 registered licenses in different health care specialties including Other Service Providers / Specialist, Allopathic & Osteopathic Physicians / Ophthalmology. Allopathic & Osteopathic Physicians / Ophthalmology is his primary health care specialty. Wong, Randall Vernon can be contacted via phone (703) 876-9630.

Contact Information

Primary practice address
3025 Hamaker Ct Suite 101 Fairfax VA 22031-2237
Phone: (703) 876-9630
Fax: (703) 876-0163
Website:
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Health care specialties

SpecialtyCodeLicense #State
Other Service Providers / Specialist 174400000X D0041207 Maryland
Allopathic & Osteopathic Physicians / Ophthalmology 207W00000X D0041207 Maryland

Profile Details

NPI number 1851397988
LBN Legal business name Wong, Randall Vernon
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Jun 23rd, 2005
Last updated Jun 13th, 2016 - about 10 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1851397988 NPPES
Maryland MEDICAID 497691600

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