DR. DONALD DUANE VANFOSSAN (NPI# 1336219930) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1336219930 |
| Entity Type | Individual |
| Full Name | DR. DONALD DUANE VANFOSSAN |
| Credential | M.D. |
| Practice Address |
201 Clinton Rd Suite 106 Jackson CA 95642-2648 |
| Mailing Address |
19200 Mountain View Way Volcano CA 95689-9707 |
| Practice Telephone | 2092233021 |
| Mailing Telephone | 2092963163 |
| Enumeration Date | 2006-11-09 |
| Last Update Date | 2007-07-08 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2084N0400X |
Psychiatry & Neurology Specialization: Neurology |
00G577420 | CA | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| CA | 00G577420 | 05 |
| Street Address |
201 CLINTON RD SUITE 106 |
| City | JACKSON |
| State | CA |
| Zip Code | 95642-2648 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1083715254 | Kenny K. Charn | Internal Medicine | 201 Clinton Rd, Suite 105, Jackson, CA 95642-2648 | 2006-09-26 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1932666575 | Gold Country Health Initiative, LLC | Family Medicine | 820/830 State Highway 88, Jackson, CA 95642 | 2019-03-01 |
| 1053844902 | Kathryn Erosa | Pharmacist | 515 Highway 49 South, Jackson, CA 95642 | 2017-04-07 |
| 1356882039 | Thomas Alan Bowhay | Clinic/Center | 820 Highway 88, Jackson, CA 95642 | 2017-03-15 |
| 1710130141 | Roland E Womack | Dentist | 511 Sutter St, Jackson, CA 95642 | 2008-10-29 |
| 1508929522 | Stanley M Ordonez | Dentist | 645 New York Ranch Rd, Jackson, CA 95642 | 2006-12-19 |
| 1942374996 | Thomas W Zeiler | Chiropractor | 665 New York Ranch Rd Suite 2, Jackson, CA 95642 | 2006-11-20 |
| 1023188968 | Cordelia Rose Slayter | Physical Therapist | 711 S State Hwy 49, Jackson, CA 95642 | 2006-11-08 |
| 1285744946 | Raleys | Pharmacy | 781 South Highway 49, Jackson, CA 95642 | 2006-08-30 |
| 1316996747 | Robert R. Bussell X | Physical Therapist | 813 Court Street, Ste 2, Jackon, CA 95642 | 2006-05-10 |
| 1861953135 | Chelsea Yule Solutions | Clinic/Center | 230 N Main St, Jackson, CA 95642 | 2019-03-28 |
| Find all providers in zip 95642 | ||||
| Taxonomy Code | 2084N0400X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Psychiatry & Neurology |
| Specialization | Neurology |
| A Neurologist specializes in the diagnosis and treatment of diseases or impaired function of the brain, spinal cord, peripheral nerves, muscles, autonomic nervous system, and blood vessels that relate to these structures. |
| Notes: Source: The American Board of Psychiatry and Neurology, Inc. www.abpn.com [1/1/2007: new definition] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1235454059 | Mitchell Myers, M.d. | Psychiatry & Neurology | 2906 North State Street, Suite 301, Jackson, MS 39216 | 2010-04-05 |
| 1477745842 | Catherine Haynes Wuthrich | Psychiatry & Neurology | 2092 Lilac Lane, Jackson, WY 83002 | 2007-08-09 |
| 1003907460 | Patrick E Weldon | Psychiatry & Neurology | 1860 Chadwick Drive, Suite 258, Jackson, MS 39204 | 2006-09-28 |
| 1801991401 | James H Spruill Jr. | Psychiatry & Neurology | 614 Skyline Dr, Jackson, TN 38301-3923 | 2006-09-14 |
| 1174628903 | Michael W Brueggeman | Psychiatry & Neurology | 700 West Forest, Ste 200, Jackson, TN 38301 | 2006-09-14 |
| 1417962952 | Mohamad R Karami-sichani | Psychiatry & Neurology | 50 Bent Creek Ln, Jackson, TN 38305-2170 | 2006-07-31 |
| 1760427496 | Sumathira T Sathanandan | Psychiatry & Neurology | 700 West Forest, Ste. 200, Jackson, TN 38301 | 2006-06-17 |
| 1174574701 | Kathleen A. Messenger | Psychiatry & Neurology | 971 Lakeland Dr Ste 557, Jackson, MS 39216-4661 | 2006-05-16 |
| 1669430708 | Aida Bodour | Psychiatry & Neurology | 1400 E Michigan Ave, Jackson, MI 49202-3518 | 2006-05-01 |
| 1891751806 | Umesh Verma | Psychiatry & Neurology | 1418 E Michigan Ave, Jackson, MI 49202-3518 | 2006-04-26 |
| Find all providers in JACKSON | ||||
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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.