Provider Demographics
NPI:1194797704
Name:ACHONG, DWIGHT MARK (MD)
Entity type:Individual
Prefix:DR
First Name:DWIGHT
Middle Name:MARK
Last Name:ACHONG
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Gender:M
Credentials:MD
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Mailing Address - Street 1:13000 BRUCE B DOWNS BLVD
Mailing Address - Street 2:NUCLEAR MEDICINE (115)
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33612-4745
Mailing Address - Country:US
Mailing Address - Phone:813-972-7538
Mailing Address - Fax:813-978-5854
Practice Address - Street 1:13000 BRUCE B DOWNS BLVD
Practice Address - Street 2:NUCLEAR MEDICINE (115)
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33612-4745
Practice Address - Country:US
Practice Address - Phone:813-972-7538
Practice Address - Fax:813-978-5854
Is Sole Proprietor?:No
Enumeration Date:2006-02-07
Last Update Date:2012-02-08
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Provider Licenses
StateLicense IDTaxonomies
FLME81649207UN0902X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207UN0902XAllopathic & Osteopathic PhysiciansNuclear MedicineNuclear Imaging & Therapy