Provider Demographics
NPI:1467797803
Name:COMPLETE FAMILY CARE, LLC
Entity type:Organization
Organization Name:COMPLETE FAMILY CARE, LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN
Authorized Official - Prefix:
Authorized Official - First Name:YOYEN
Authorized Official - Middle Name:A
Authorized Official - Last Name:LAU
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:256-312-8939
Mailing Address - Street 1:213 S 5TH ST
Mailing Address - Street 2:
Mailing Address - City:GADSDEN
Mailing Address - State:AL
Mailing Address - Zip Code:35901-4217
Mailing Address - Country:US
Mailing Address - Phone:256-312-8939
Mailing Address - Fax:256-312-5132
Practice Address - Street 1:213 S 5TH ST
Practice Address - Street 2:
Practice Address - City:GADSDEN
Practice Address - State:AL
Practice Address - Zip Code:35901-4217
Practice Address - Country:US
Practice Address - Phone:256-312-8939
Practice Address - Fax:256-438-5132
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-12-11
Last Update Date:2025-02-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ALD0638207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL123504Medicaid
ALG27837Medicare UPIN
AL051559163Medicare PIN