Cecilia B Ong, M.D.
Individual provider Active NPI Specialist · Ludowici, GA
NPI 1669798989 · NPPES record last updated Aug 11, 2010
Key facts
- NPI
- 1669798989
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Specialist 174400000X
- License
- 017713 (GA)
- Practice address
- 213 North McDonald Street
Suite a & B
Ludowici, GA 31316 - Phone
- (912) 545-9398
- Fax
- (912) 545-0079
- NPI assigned
- Apr 12, 2010
- Sex
- Female
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 017713 | GA | MD | Specialist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Specialist | 174400000X | 017713 | GA | Yes |
Addresses
Primary practice location
213 North McDonald Street
Suite a & B
Ludowici, GA 31316
Mailing address
PO Box 554
Ludowici, GA 31316-0554
Phone (912) 545-9398
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 000083234G | Medicaid | GA | |
| 000083234F | Medicaid | GA |
Other providers in Ludowici, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 11, 2010. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.