Fagan, Paul Anthony

Fagan, Paul Anthony is an individual health care provider with primary practice located at 855 N Westhaven Dr , Oshkosh WI 54904-7668. He recently has only one registered license in Allopathic & Osteopathic Physicians / Orthopaedic Surgery, which is considered as his primary health care specialty. Fagan, Paul Anthony can be contacted via phone (920) 303-8700.

Contact Information

Primary practice address
855 N Westhaven Dr Oshkosh WI 54904-7668
Fax: (920) 303-8801
Website:

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Orthopaedic Surgery 207X00000X 5101018111 Michigan
Allopathic & Osteopathic Physicians / Orthopaedic Surgery 207X00000X 63870-021 Wisconsin

Profile Details

NPI number 1063646305
LBN Legal business name Fagan, Paul Anthony
Credentials Doctor of Osteopathy (DO)
Entity Individual
Sole proprietor 1 No
Enumeration date May 14th, 2009
Last updated Dec 8th, 2023 - about 2 years ago

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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Identifiers

StateTypeNumberIssuer
All States NPI 1063646305 NPPES
Wisconsin MEDICAID 100046679

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