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Brian Wong — NPI 1124474960, Eagle, ID | NPI Central

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NPI 1124474960

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Brian Wong

NPI 1124474960 · Pediatrics Physician · Eagle, ID

Provider details

NPI number: 1124474960
Entity type: Individual
Primary specialty: Pediatrics PhysicianAllopathic & Osteopathic Physicians
Sex: Male
Sole proprietor: No

Practice location

3217 W Bavaria St

Eagle, ID 83616-5171

Phone: (208) 302-6200

Fax: (208) 302-6245

More ID providers

Mailing address

Po Box 190930

Boise, ID 83719-0930

Registry dates

Enumerated: 2016-05-11
Last updated: 2025-06-02

Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.