DR. ALAIN L DOMKAM-FONDJO (NPI# 1962603886) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1962603886 |
| Entity Type | Individual |
| Full Name | DR. ALAIN L DOMKAM-FONDJO |
| Credential | MD |
| Practice Address |
302 8th St Greenwood MS 38930-4014 |
| Practice Telephone | 6624514570 |
| Practice Fax Number | 6624515140 |
| Mailing Telephone | 6624514570 |
| Mailing Fax Number | 6624515140 |
| Enumeration Date | 2007-05-29 |
| Last Update Date | 2018-12-06 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2086S0129X |
Surgery Specialization: Vascular Surgery |
19760 | MS | Allopathic & Osteopathic Physicians |
| Street Address |
302 8TH ST |
| City | GREENWOOD |
| State | MS |
| Zip Code | 38930-4014 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1578522934 | Raymond Girnys | Surgery | 302 8th St, Greenwood, MS 38930-4014 | 2006-03-22 |
| 1184683542 | Greenwood Leflore Hospital | Surgery | 302 8th St, Greenwood, MS 38930 | 2006-03-22 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1447871579 | Stewart Health Care Training Academy | Home Health Aide | 522 West Park Avenue Suite S, Greenwood, MS 38930 | 2020-04-29 |
| 1801386487 | Sunflower-humphreys Counties Progress, Inc. | Case Management | 414 Martin Luther King Dr, Indianola, MS 38930 | 2018-05-18 |
| 1053826610 | Sarah Malone | Counselor | 2504 Browing Road, Greenwood, MS 38930 | 2017-12-05 |
| 1780109850 | Jasmine Turner Edwards | Pharmacist | 2202 Us 82 W Frontage Rd, Greenwood, MS 38930 | 2017-08-09 |
| 1861916199 | Maurice Wright | Social Worker | 522 West Park Avenue, Suite Q-r, Greenwood, MS 38930 | 2017-07-28 |
| 1215464607 | Catherine Johnson | Counselor | 522 West Park Avenue, Greenwood, MS 38930 | 2017-05-16 |
| 1598205262 | Vignesh Kannan | Internal Medicine | Greenwood Leflore Hospital, 1401 River Rd, Greenwood, MS 38930 | 2017-03-01 |
| 1952847691 | Mischa Mccray | Counselor | 804 E Park Ave, Greenwood, MS 38930 | 2017-01-18 |
| 1760933147 | Ginger Caldero | Social Worker | 522 West Park Ave, Greenwood, MS 38930 | 2016-10-20 |
| 1942750617 | Greenwood Leflore Hospital | Psychiatry & Neurology | 1401 River Rd Rm 534, Greenwood, MS 38930 | 2016-10-06 |
| Find all providers in zip 38930 | ||||
| Taxonomy Code | 2086S0129X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Surgery |
| Specialization | Vascular Surgery |
| A surgeon with expertise in the management of surgical disorders of the blood vessels, excluding the intracranial vessels or the heart. |
| 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 Surgery, 2007. http://www.absurgery.org/. American Osteopathic Board of Surgery, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Surgery. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Surgery. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1962952689 | Capel Vascular Center, LLC | Surgery | 408 E Washington St, Greenwood, MS 38930-4539 | 2016-10-05 |
| 1508145855 | Greenwood Leflore Hospital | Surgery | 501 W Washington St, Greenwood, MS 38930 | 2011-08-04 |
| 1104131143 | Anas Abdel Azim | Surgery | 160 Academy Ave, Greenwood, SC 29646-3808 | 2010-08-14 |
| 1619083060 | Jeffrey E Lanford | Surgery | 160 Academy Ave, Greenwood, SC 29646-3808 | 2006-08-21 |
| 1154437515 | Greenwood Surgical Assoc. | Surgery | 160 Academy Ave, Greenwood, SC 29646-3808 | 2006-08-21 |
| 1184683542 | Greenwood Leflore Hospital | Surgery | 302 8th St, Greenwood, MS 38930 | 2006-03-22 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1104323534 | Best Vein Care of Mississippi, LLC | Surgery | 204 W Jackson St Ste A, Ridgeland, MS 39157-2310 | 2018-04-11 |
| 1457714172 | Flowood Medical Management LLC | Surgery | 4800 Lakeland Dr, Flowood, MS 39232-8694 | 2016-03-30 |
| 1982009031 | Magnolia General and Vascular Surgery Clinic | Surgery | 611 Alcorn Dr Ste 210, Corinth, MS 38834-9323 | 2014-10-31 |
| 1730406729 | Alexander H. Nguyen | Surgery | 4503 M St, Biloxi, MS 39530 | 2010-04-29 |
| 1952557092 | Medical Foundation of Central Mississippi, Inc | Surgery | 501 Marshall St Ste 100, Jackson, MS 39202-1687 | 2008-08-08 |
| 1730243064 | Frank A Nichols | Surgery | 1040 A So Madison, Tupelo, MS 38801 | 2006-12-21 |
| 1427073386 | Edward E Rigdon | Surgery | 348 Crossgates Blvd, Suite 2500, Brandon, MS 39042-2700 | 2006-07-13 |
| 1174556377 | Seshadri Raju, M.d., Pa. | Surgery | 971 Lakeland Dr Ste 401, Jackson, MS 39216 | 2006-07-09 |
| 1790760692 | Surgery Associates Pa | Surgery | 440 Pegram Dr, Tupelo, MS 38801-6319 | 2005-12-13 |
| 1396226791 | North Mississippi Medical Center, Inc | Surgery | 616 Alcorn Dr, Corinth, MS 38834-9393 | 2018-08-23 |
| 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.