Fagan, Jake
Fagan, Jake is an individual health care provider with primary practice located at 1055 N 500 W # 111 , Provo UT 84604-3305. He recently has 4 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Dermatology, Allopathic & Osteopathic Physicians / MOHS-Micrographic Surgery, Allopathic & Osteopathic Physicians / Surgical Oncology, Student, Health Care / Student in an Organized Health Care Education/Training Program. Allopathic & Osteopathic Physicians / MOHS-Micrographic Surgery is his primary health care specialty. Fagan, Jake can be contacted via phone (801) 374-8999.Contact Information
Health care specialties
Specialty | Code | License # | State |
---|---|---|---|
Allopathic & Osteopathic Physicians / Dermatology | 207N00000X | MED-PHYS-LIC-76211 | Montana |
Allopathic & Osteopathic Physicians / MOHS-Micrographic Surgery | 207ND0101X | MED-PHYS-LIC-76211 | Montana |
Allopathic & Osteopathic Physicians / MOHS-Micrographic Surgery | 207ND0101X | 76211 | Montana |
Allopathic & Osteopathic Physicians / Surgical Oncology | 2086X0206X | MED-PHYS-LIC-76211 | Montana |
Student, Health Care / Student in an Organized Health Care Education/Training Program | 390200000X | ||
Allopathic & Osteopathic Physicians / MOHS-Micrographic Surgery | 207ND0101X | 6845592-1205 | Utah |
Profile Details
NPI number | 1548688989 |
---|---|
LBN Legal business name | Fagan, Jake |
Credentials | Doctor of Medicine (MD) |
Entity | Individual |
Sole proprietor 1 | No |
Enumeration date | Apr 2nd, 2014 |
Last updated | Apr 17th, 2024 - about last year |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
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