DR. MICHAEL FONG (NPI# 1437512894) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1437512894 |
| Entity Type | Individual |
| Full Name | DR. MICHAEL FONG |
| Credential | D.O. |
| Practice Address |
315 S Osteopathy Ave Kirksville MO 63501-6401 |
| Practice Telephone | 6607851000 |
| Enumeration Date | 2016-04-03 |
| Last Update Date | 2020-04-30 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 390200000X | Student in an Organized Health Care Education/Training Program | Student, Health Care |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MO | 200072106 | 05 |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 1316 Country Club Dr, Kirksville, MO 635015362 | 6606277546 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1285891523 | Michael J Fong | Dentist | 2500 Hospital Dr # 6, Mountain View, CA 94040-4106 | 2008-05-22 |
| 1801388111 | Michael Wang Keong Fong | Student in an Organized Health Care Education/Training Program | 20 York Street, Ynhh Tompkins 226, New Haven, CT 06510-3220 | 2018-06-01 |
| 1568668366 | Michael Ka Ho Fong | Surgery | 4950 W Sunset Blvd, 4th Floor, Los Angeles, CA 90027-5822 | 2007-06-27 |
| 1871634311 | Michael Fong | Case Manager/Care Coordinator | 310 8th St Ste 201, Oakland, CA 94607-6527 | 2007-02-09 |
| 1235217084 | Michael Lee Fong | Internal Medicine | 3553 Whipple Rd, Union City, CA 94587-1507 | 2006-11-01 |
| 1407863756 | Michael William Fong | Internal Medicine | 1520 San Pablo St, Suite 1000, Los Angeles, CA 90033-5310 | 2006-08-01 |
| Street Address |
315 S OSTEOPATHY AVE |
| City | KIRKSVILLE |
| State | MO |
| Zip Code | 63501-6401 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1932185154 | Sheri E Brinser | Anesthesiology | 315 S Osteopathy Ave, Kirksville, MO 63501-6401 | 2005-12-20 |
| 1700487808 | Dominick Jay Wright | Family Medicine | 315 S Osteopathy Ave, Kirksville, MO 63501-6401 | 2020-11-04 |
| 1205444999 | Jared Huffman | Neuromusculoskeletal Medicine & OMM | 315 S Osteopathy Ave, Kirksville, MO 63501-6401 | 2020-07-19 |
| 1720606023 | Ripley Emergency Group, LLC | Physician Assistant | 315 S Osteopathy Ave, Kirksville, MO 63501-6401 | 2020-07-13 |
| 1053939363 | Katherine Lynne Holbrook | Family Medicine | 315 S Osteopathy Ave, Kirksville, MO 63501-6401 | 2020-07-13 |
| 1013535988 | Olaf Js Samuelson | Family Medicine | 315 S Osteopathy Ave, Kirksville, MO 63501-6401 | 2020-07-08 |
| 1285252973 | Cameron Sinclair Olsen | Internal Medicine | 315 S Osteopathy Ave, Kirksville, MO 63501-6401 | 2020-07-08 |
| 1710505557 | Sydney Priest | Family Medicine | 315 S Osteopathy Ave, Kirksville, MO 63501-6401 | 2020-07-08 |
| 1407473614 | Courtney Plachno | Neuromusculoskeletal Medicine & OMM | 315 S Osteopathy Ave, Kirksville, MO 63501-6401 | 2020-07-03 |
| 1730706243 | Melissa Anne Mann | Internal Medicine | 315 S Osteopathy Ave, Attn Dme Office, Kirksville, MO 63501-6401 | 2020-06-30 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1245855642 | Tiffany Anna Athon | Pharmacist | Hy-vee Pharmacy, 500 N Baltimore, Kirksville, MO 63501 | 2020-06-11 |
| 1649829425 | Jillian Jo Pulis | Speech-Language Pathologist | 1300 S Cottage Ave, Kirksville, MO 63501 | 2019-09-05 |
| 1023662319 | Leah Dawn Murphy | Occupational Therapy Assistant | 1705 E La Harpe St, Kirksville, MO 63501 | 2019-07-25 |
| 1902302912 | Brittney Frances Snelling | Specialist/Technologist | 26820 State Hwy 11, Kirksville, MO 63501 | 2018-03-30 |
| 1063931434 | Kara Wehmeyer | Specialist/Technologist | 100 East Normal, Kirksville, MO 63501 | 2017-09-16 |
| 1285080796 | Hawkins Boone Mecham | General Practice | 407 S Main St # 2, Kirksville, MO 63501 | 2016-05-13 |
| 1003287848 | Lacosta Gaines | Nurse Practitioner | 1607 South Baltimore, Kirksville, MO 63501 | 2015-10-19 |
| 1427442573 | Madi Hoppe | Specialist/Technologist | 23571 Crest Trail, Kirksville, MO 63501 | 2015-03-26 |
| 1407247133 | High Hope Employment Services, Inc. | Day Training, Developmentally Disabled Services | 906 East Shepherd Avenue, Kirksville, MO 63501 | 2015-02-17 |
| 1497069694 | Ella Marie Callison | Physician Assistant | 1611 S Baltimore St Ste A, Kirksville, MO 63501 | 2010-07-29 |
| Find all providers in zip 63501 | ||||
| Taxonomy Code | 390200000X |
| Grouping | Student, Health Care |
| Classification | Student in an Organized Health Care Education/Training Program |
| An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care. |
| Notes: [1/1/2005: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1225651003 | John Dylan Pate | Student in an Organized Health Care Education/Training Program | 800 W Jefferson St, Kirksville, MO 63501-1443 | 2020-05-27 |
| 1720636939 | Kylie Hayes | Student in an Organized Health Care Education/Training Program | 113 E Washington St Ste 9, Kirksville, MO 63501-2987 | 2019-08-30 |
| 1225699481 | Nathan Joseph Conrad Needham | Student in an Organized Health Care Education/Training Program | 315 S Osteopathy Ave, Kirksville, MO 63501-6401 | 2019-06-27 |
| 1962975607 | Angela D Peper | Student in an Organized Health Care Education/Training Program | 800 W Jefferson St, Kirksville, MO 63501-1443 | 2019-01-04 |
| 1184191025 | Chad Verdier | Student in an Organized Health Care Education/Training Program | 100 E Normal Ave, Kirksville, MO 63501-4221 | 2018-10-30 |
| 1326523317 | Grace Pepple | Student in an Organized Health Care Education/Training Program | 100 E Normal Ave, Kirksville, MO 63501-4200 | 2018-09-26 |
| 1932683653 | Elizabeth Mary Roberts | Student in an Organized Health Care Education/Training Program | 315 S Osteopathy Ave, Kirksville, MO 63501-6401 | 2018-09-18 |
| 1205313152 | Joshua Moody | Student in an Organized Health Care Education/Training Program | 315 S Osteopathy Ave, Kirksville, MO 63501-6401 | 2018-07-24 |
| 1669993747 | Todd Nicholas Troxell | Student in an Organized Health Care Education/Training Program | 315 S Osteopathy Ave, Kirksville, MO 63501-6401 | 2017-06-29 |
| 1285164772 | Elizabeth Demaree | Student in an Organized Health Care Education/Training Program | 1316 Country Club Dr, Kirksville, MO 63501 | 2017-06-15 |
| Find all providers in KIRKSVILLE | ||||
| City | KIRKSVILLE |
| Zip Code | 63501 |
Please comment or provide details below to improve the information on DR. MICHAEL FONG.
| 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.