IndividualActive
Alain Fondjo Domkam, MD
NPI 1962603886 · Vascular Surgery Physician · Greenwood, MS
Provider details
- NPI number
- 1962603886
- Entity type
- Individual
- Primary specialty
- Vascular Surgery PhysicianAllopathic & Osteopathic Physicians
- Credential
- MD
- Sex
- Male
- Sole proprietor
- No
- License
- 19760 (MS)
Specialties & taxonomies
Allopathic & Osteopathic Physicians
Practice location
302 8th St
Greenwood, MS 38930-4014
Phone: (662) 451-4570
Fax: (662) 451-5140
Approximate (ZIP-level) locationGet directions
Mailing address
302 8th St
Greenwood, MS 38930-4014
Registry dates
- Enumerated
- 2007-05-29
- Last updated
- 2024-10-25
- Certified
- 2024-10-23
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.