FAZLE MATIN (NPI# 1053452417) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1053452417 |
| Entity Type | Individual |
| Full Name | FAZLE MATIN |
| Credential | MD |
| Practice Address |
203 West Lee Street Tuskegee AL 36083 |
| Practice Telephone | 3347277050 |
| Practice Fax Number | 3347276284 |
| Mailing Telephone | 3347277050 |
| Mailing Fax Number | 3347276284 |
| Enumeration Date | 2007-02-09 |
| Last Update Date | 2007-07-08 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 208000000X | Pediatrics | 00022310 | AL | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| AL | BC | 51005213 | 01 |
| AL | 631000021 | 05 |
| Street Address |
203 WEST LEE STREET |
| City | TUSKEGEE |
| State | AL |
| Zip Code | 36083 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1790726867 | Lasan Davis | Family Medicine | 203 West Lee Street, Tuskegee, AL 36083 | 2006-06-09 |
| 1982929519 | Tony A Bodiford | Pharmacist | 203 West Lee Street, Tuskegee, AL 36083-1714 | 2010-04-07 |
| 1518282144 | Adrian Taylor | Pharmacy Technician | 203 West Lee Street, Tuskegee, AL 36083-1714 | 2010-04-07 |
| 1215078159 | Central Alabama Comprehensive Health Inc | Clinic/Center | 203 West Lee Street, Tuskegee, AL 36083 | 2007-02-12 |
| 1760523609 | Danilo Judit | Internal Medicine | 203 West Lee Street, Tuskegee, AL 36083 | 2007-02-12 |
| 1790879930 | Eugene Evans | Family Medicine | 203 West Lee Street, Tuskegee, AL 36083 | 2006-10-03 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1972698587 | Nguyet H Smith | Pharmacist | Central Alabama Veterans Health Care System, Pharmacy, 2400 Hospital Road, Tuskegee, AL 36083 | 2006-10-03 |
| 1619908795 | Carmen Elizabeth Beverly | Podiatrist | Cavhcs 2400 Hospital Rd, Dm Clinic, Tuskegee, AL 36083 | 2006-07-06 |
| 1275564635 | Tim Landers | Audiologist | 2400 Hospital Rd., Cavhcs - 126, Tuskegee, AL 36083 | 2006-07-05 |
| 1831144344 | Denise Free Lensgraf-landers | Audiologist | Cavhcs Audiology (117), 2400 Hospital Road, Tuskegee, AL 36083 | 2006-05-23 |
| 1396705836 | Mark Patrick Mcguire | Optometrist | 2400 Hosptial Road, Eye Clinic Cavhcs, Tuskegee, AL 36083 | 2006-03-27 |
| 1164402863 | Lisa R Green | Optometrist | 2400 Hospital Rd Bldg 3, Tuskegee, AL 36083 | 2006-01-19 |
| 1265775936 | Shari Smith | Social Worker | 2400 Hospital Rd., Cavhcs- Social Work Services, Tuskegee, AL 36083 | 2013-04-01 |
| 1689902710 | Penny M Genous | Social Worker | 2400 Hospital Rd, Tuskegee, AL 36083 | 2009-12-01 |
| 1194954255 | Kevin Mcbeth Johnson | Student in an Organized Health Care Education/Training Program | 2400 Hospital Rd, Tuskegee, AL 36083 | 2009-07-10 |
| 1861638025 | Andrea Darmyka Steen | Social Worker | 2400 Hospital Road, Tuskegee, AL 36083 | 2008-12-18 |
| Find all providers in zip 36083 | ||||
| Taxonomy Code | 208000000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Pediatrics |
| A pediatrician is concerned with the physical, emotional and social health of children from birth to young adulthood. Care encompasses a broad spectrum of health services ranging from preventive healthcare to the diagnosis and treatment of acute and chronic diseases. A pediatrician deals with biological, social and environmental influences on the developing child, and with the impact of disease and dysfunction on development. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Pediatrics, 2007. http://www.abp.org/. American Osteopathic Board of Pediatrics, 2007. http://www.osteopathic.org/certificatio - Board certification for Medical Doctors (MDs) is provided by the American Board of Pediatrics. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Pediatrics. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1790844819 | Southeast Pediatrics | Pediatrics | 804 Crawford St, Tuskegee, AL 36083-7262 | 2006-12-06 |
| 1770772923 | Mollie Ann Walker | Pediatrics | 804 Crawford St, Tuskegee, AL 36083-7262 | 2007-10-23 |
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|---|---|---|---|---|
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| 1922615749 | Smart Care, LLC | Pediatrics | 801 North St E, Talladega, AL 35160-2529 | 2020-09-25 |
| 1124667415 | Brittany Johnson Mccullough | Pediatrics | 134 Foothills Pkwy, Chelsea, AL 35043-8179 | 2020-01-03 |
| 1982240941 | Heritage Pediatrics LLC | Pediatrics | 3358 Highway 280, Suite 108, Alexander City, AL 35010 | 2019-11-25 |
| 1952945602 | East Montgomery Pediatrics LLC | Pediatrics | 337 St Lukes Drive, Montgomery, AL 36117 | 2019-11-05 |
| 1326699190 | Kids Cove Pediatrics | Pediatrics | 19 Abby Glen Way, Gurley, AL 35748-8035 | 2019-09-24 |
| 1386290781 | Deshazo Medical | Pediatrics | 4387 Boulder Lake Cir, Vestavia, AL 35242-2116 | 2019-08-13 |
| 1477013720 | Decatur Morgan Pediatrics | Pediatrics | 1215 7th St Se Ste 210, Decatur, AL 35601-3385 | 2019-03-22 |
| 1801367107 | Tera Walters Therapy LLC | Pediatrics | 2523 D'iberville Drive North, Mobile, AL 36695 | 2018-12-12 |
| 1629573928 | Kaitlyn Brown Parker | Pediatrics | 2451 Usa Medical Center Dr Rm 714, Mobile, AL 36617-2300 | 2018-03-28 |
| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.