Individual provider · Type 1 NPI
Alain Lesage Fondjo Domkam, MD
Vascular Surgery Physician · Greenwood, MS
NPI number
1962603886
Active
Practice location
302 8th St
Greenwood, MS 38930-4014
Fax (662) 451-5140
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Vascular Surgery Physician Primary | 2086S0129X | 19760 (MS) |
Vascular Surgery Physician: A surgeon with expertise in the management of surgical disorders of the blood vessels, excluding the intracranial vessels or the heart.
About NPI 1962603886
Alain Lesage Fondjo Domkam, MD's National Provider Identifier is 1962603886, issued on May 29, 2007. The primary taxonomy on file is Vascular Surgery Physician (2086S0129X), and the practice location is in Greenwood, MS. The record was last updated on Oct 25, 2024.