Dr Christine Janel Haywood Bong, MD, FAAP, MPH | |
2960 N Circle Dr Ste 200, Colorado Springs, CO 80909-1163 | |
(719) 634-8891 | |
Not Available |
Full Name | Dr Christine Janel Haywood Bong |
---|---|
Gender | Female |
Speciality | Pediatrics |
Location | 2960 N Circle Dr Ste 200, Colorado Springs, Colorado |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1992827653 | NPI | - | NPPES |
37336843 | Medicaid | CO | |
LL28136 | Other | SC | LIMITED MEDICAL LICENSE |
CO306759 | Other | CO | MEDICARE PTAN |
47375 | Other | CO | MEDICAL LICENSE |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
208000000X | Pediatrics | 47375 (Colorado) | Primary |
208000000X | Pediatrics | LL28136 (South Carolina) | Secondary |
Entity Name | Restore Health Family Practice |
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Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1295312288 PECOS PAC ID: 9537577762 Enrollment ID: O20210428000012 |
Mailing Address | Practice Location Address |
---|---|
Dr Christine Janel Haywood Bong, MD, FAAP, MPH 7625 Slate Ct, Colorado Springs, CO 80919-2922 Ph: (719) 313-3267 | Dr Christine Janel Haywood Bong, MD, FAAP, MPH 2960 N Circle Dr Ste 200, Colorado Springs, CO 80909-1163 Ph: (719) 634-8891 |
Dr. Caroline Balet Rowlands, M.D. Pediatrics Medicare: Medicare Enrolled Practice Location: 2610 Tenderfoot Hill Street, Colorado Springs, CO 80906 Phone: 719-538-5727 Fax: 719-226-8629 | |
Lisa Cunningham, MD Pediatrics Medicare: Not Enrolled in Medicare Practice Location: 2620 Tenderfoot Hill St, Suite 100, Colorado Springs, CO 80906 Phone: 719-576-7006 Fax: 719-576-7981 | |
Natalie Connolly, MD Pediatrics Medicare: Medicare Enrolled Practice Location: 4150 E Woodmen Rd Ste 100, Colorado Springs, CO 80920 Phone: 719-632-4455 | |
Amanda Marie Nedzinski, D.O. Pediatrics Medicare: Medicare Enrolled Practice Location: 6071 E Woodmen Rd Ste 225, Colorado Springs, CO 80923 Phone: 719-571-7130 Fax: 719-571-7152 | |
Dr. Audrey Mae Hall, MD Pediatrics Medicare: Medicare Enrolled Practice Location: 4105 Briargate Pkwy, Suite #125, Colorado Springs, CO 80920 Phone: 303-338-4545 | |
Dr. Kenneth A. Richeaux, M.D. Pediatrics Medicare: Medicare Enrolled Practice Location: 2610 Tenderfoot Hill St, Colorado Springs, CO 80906 Phone: 719-538-5727 Fax: 719-226-8629 | |
Charity L Jackson, M.D. Pediatrics Medicare: Not Enrolled in Medicare Practice Location: 402 N Tejon St Ste 200, Colorado Springs, CO 80903 Phone: 719-633-3850 Fax: 719-227-0840 |