EVERGREEN MEDICAL COSMETIC LASER CENTER (NPI# 1992144240) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1992144240 |
| Entity Type | Organization |
| Organization Name | EVERGREEN MEDICAL COSMETIC LASER CENTER |
| Practice Address |
104 1st Ave East Oneonta AL 35121 |
| Mailing Address |
1638 Crossgate Dr Birmingham AL 35216 |
| Practice Telephone | 2058342672 |
| Mailing Telephone | 2058342672 |
| Enumeration Date | 2013-06-20 |
| Last Update Date | 2013-06-20 |
| Authorized Official Name | DR. JIAN HUAI FONG (MD) |
| Authorized Official Telephone | 2058342672 |
| Authorized Official Credential | MD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QP2300X |
Clinic/Center Specialization: Primary Care |
27530 | AL | Ambulatory Health Care Facilities |
| Street Address |
104 1ST AVE EAST |
| City | ONEONTA |
| State | AL |
| Zip Code | 35121 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1104430446 | Victory Health of Oneonta LLC | Nurse Practitioner | 28252 Al-75, Oneonta, AL 35121 | 2020-09-03 |
| 1023588688 | Melissa Kay Thompson | Counselor | 25522 Al-75, Oneonta, AL 35121 | 2018-11-27 |
| 1497105274 | Kendra Nicole Menghini | Specialist/Technologist | 27550 Al-75 Suite 102, Oneonta, AL 35121 | 2016-06-13 |
| 1871725382 | Renay Horsley Carroll | Counselor | 898 Springville Blvd, Oneonta, AL 35121 | 2009-08-17 |
| 1801051354 | Express Care Clinic of Oneonta, P.C. | Internal Medicine | 2040 2nd Avenue East, Oneonta, AL 35121 | 2008-07-24 |
| 1962526665 | Blount Co Mrdd, Inc | Case Management | 406 5th St N, Suite 5 & 6, Oneonta, AL 35121 | 2007-03-19 |
| 1629138714 | Miller Drug Co Inc | Pharmacy | 212 1st Ave East, Oneonta, AL 35121 | 2006-12-11 |
| 1154426534 | Jay E Hypes | Dentist | 52 Valley Rd, Oneonta, AL 35121 | 2006-09-13 |
| 1477667376 | Pharmacy Inc | Pharmacy | 27550 State Hwy 75, Suite #107, Oneonta, AL 35121 | 2006-08-18 |
| 1154885093 | Narda F Harp | Counselor | 25522 Al-75, 25522 Al-75, Oneonta, AL 35121 | 2019-01-24 |
| Find all providers in zip 35121 | ||||
| Taxonomy Code | 261QP2300X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Primary Care |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1831736339 | Affordable Care of Oneonta | Clinic/Center | 908 2nd Ave E, Oneonta, AL 35121-2506 | 2019-12-03 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1891316758 | Modern Health Family Care Practice | Clinic/Center | 13000 Cottonwood Rd, Cottonwood, AL 36320-4280 | 2020-05-01 |
| 1487274650 | Faith Medical Clinic LLC | Clinic/Center | 64 Mccurdy Ave N, Rainsville, AL 35986-4465 | 2020-04-17 |
| 1386283471 | E A Mccleskey, Do, LLC | Clinic/Center | 103 Intercom Dr Ste B, Madison, AL 35758-2641 | 2020-01-06 |
| 1568012755 | Watchman's Health PC | Clinic/Center | 1501 7th St Se Ste A, Decatur, AL 35601-3375 | 2019-09-19 |
| 1184273096 | Spedale Md PC | Clinic/Center | 3113 Wesley Way Ste 1, Dothan, AL 36305-2004 | 2019-09-04 |
| 1124675459 | Mainstreet Family Care LLC | Clinic/Center | 1500 1st Ave N Unit 3, Birmingham, AL 35203-1866 | 2019-08-21 |
| 1568016004 | Fenton Chiropractic LLC | Clinic/Center | 301 1st St S, Reform, AL 35481-8013 | 2019-08-01 |
| 1568967081 | Bernice R Swain Do Pllc | Clinic/Center | 2424 Danville Rd Sw Ste L, Decatur, AL 35603-4219 | 2018-03-27 |
| 1578088001 | Coastal Health & Wellness | Clinic/Center | 14 Confederate Dr S, Spanish Fort, AL 36527-3062 | 2017-08-05 |
| 1760918494 | Killen Urgent Care, Inc. | Clinic/Center | 152 J C Mauldin Hwy, Killen, AL 35645-9106 | 2017-05-01 |
| 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.