Fong Medical Clinic, PA

Primary specialty

Clinic/CenterTaxonomy code 261Q00000X

License

39331 Issued in MN

Legal business name

FONG MEDICAL CLINIC, PA

Practice address

105 New England PL
Suite 220
Stillwater, MN 55082-5783

Phone

(651) 731-3664

Fax

(651) 430-9981

NPI assigned

Sep 15, 2006

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Dr. Milton Tan Fong, MD

Title

President

Phone

(651) 731-3664

Specialties & licenses 1

Addresses

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1158278400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1316043425",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "105 NEW ENGLAND PL",
            "address_2": "SUITE 220",
            "city": "STILLWATER",
            "state": "MN",
            "postal_code": "550825783",
            "telephone_number": "651-731-3664",
            "fax_number": "651-430-9981"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "105 NEW ENGLAND PL",
            "address_2": "SUITE 220",
            "city": "STILLWATER",
            "state": "MN",
            "postal_code": "550825783",
            "telephone_number": "651-731-3664",
            "fax_number": "651-430-9981"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FONG MEDICAL CLINIC, PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-15",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "FONG",
        "authorized_official_first_name": "MILTON",
        "authorized_official_middle_name": "TAN",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "651-731-3664",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": "MN",
            "license": "39331",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Paul Flanders, PHARMD
• Nancy A Flinn, OTR/L
• Philip V. Flodin
• Hedit Florido-Bergad, DNP
• Fluid Health and Fitness
• Jo Ann Ford, MSE LP
• Breynne Stacey Fordahl, D.D.S.
• Daniel Forest, D.C., C.L.S.
• Lindith M Fortin-Case, MSSW
• Teal J Foster, NP-C

• Clinic/Center in Stillwater, MN
• Providers in Stillwater, MN by specialty
• Clinic/Center in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.