Bong, Gary William

Bong, Gary William is an individual health care provider with primary practice located at 6071 E Woodmen Rd Suite 300, Colorado Springs CO 80923-2607. He recently has only one registered license in Allopathic & Osteopathic Physicians / Urology, which is considered as his primary health care specialty. Bong, Gary William can be contacted via phone (719) 531-7007.

Contact Information

Primary practice address
6071 E Woodmen Rd Suite 300 Colorado Springs CO 80923-2607
Phone: (719) 531-7007
Fax: (719) 531-7122
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Urology 208800000X 47336 Colorado

Profile Details

NPI number 1093896144
LBN Legal business name Bong, Gary William
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Oct 17th, 2006
Last updated May 4th, 2021 - about 3 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 1093896144 NPPES
Colorado MEDICAID 19852843

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