Mid-Columbia Ear, Nose & Throat, P.L.L.C.

Primary specialty

Otolaryngology PhysicianTaxonomy code 207Y00000X

License

MD00032458 Issued in WA

Legal business name

MID-COLUMBIA EAR, NOSE & THROAT, P.L.L.C.

Practice address

3903 S Irby St
Kennewick, WA 99337-2451

Phone

(509) 585-0795

NPI assigned

Apr 26, 2008

Last updated

May 10, 2008By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Randall Scott Fong, M.D.

Title

Owner

Phone

(509) 585-0795

Specialties & licenses 2

Addresses

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

{
    "created_epoch": "1209168000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1210377600000",
    "number": "1386819704",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3903 S IRBY ST",
            "city": "KENNEWICK",
            "state": "WA",
            "postal_code": "993372451",
            "telephone_number": "509-585-0795"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3903 S IRBY ST",
            "city": "KENNEWICK",
            "state": "WA",
            "postal_code": "993372451",
            "telephone_number": "509-585-0795"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MID-COLUMBIA EAR, NOSE & THROAT, P.L.L.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-04-26",
        "last_updated": "2008-05-10",
        "status": "A",
        "authorized_official_last_name": "FONG",
        "authorized_official_first_name": "RANDALL",
        "authorized_official_middle_name": "SCOTT",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "509-585-0795",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207Y00000X",
            "taxonomy_group": "",
            "desc": "Otolaryngology",
            "state": "WA",
            "license": "MD00032458",
            "primary": true
        },
        {
            "code": "231H00000X",
            "taxonomy_group": "",
            "desc": "Audiologist",
            "state": "WA",
            "license": "LD0002175",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• MH Health Care Services, PC (Pacific Health Coalition - Tri Cities)
• Michael E. Shannon, D.M.D., P.S.C. (Shannon Dental Health Center)
• Jeffrey Carl Michaelis
• Sophie Ann Michel
• Mid Columbia Ambulance LLC
• Mid-Columbia Endoscopy Center, LLC
• Mid-Columbia Medical Associates
• Mid-Columbia Ultrasound LLC
• Kayla Miele Rooney
• Darci Miland, MS

• Otolaryngology Physician in Kennewick, WA
• Providers in Kennewick, WA by specialty
• Otolaryngology Physician in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 10, 2008; 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.