Provider Demographics
NPI:1962638650
Name:ONG, SORAYA (MD)
Entity type:Individual
Prefix:DR
First Name:SORAYA
Middle Name:
Last Name:ONG
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:SORAYA
Other - Middle Name:
Other - Last Name:JAOJAROENKUL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:3633 CENTRAL AVE STE D
Mailing Address - Street 2:
Mailing Address - City:HOT SPRINGS
Mailing Address - State:AR
Mailing Address - Zip Code:71913-6475
Mailing Address - Country:US
Mailing Address - Phone:501-623-6693
Mailing Address - Fax:
Practice Address - Street 1:1910 MALVERN AVE
Practice Address - Street 2:
Practice Address - City:HOT SPRINGS NATIONAL PARK
Practice Address - State:AR
Practice Address - Zip Code:71901-7752
Practice Address - Country:US
Practice Address - Phone:501-321-1000
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-06-08
Last Update Date:2018-03-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL125056517207U00000X
IL036130694207U00000X, 2085R0202X
OH1301642085R0202X
ARE-108542085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic RadiologyGroup - Multi-Specialty
No207U00000XAllopathic & Osteopathic PhysiciansNuclear Medicine