SearchUtahMOHS-Micrographic Surgery Physician

Jake Fagan, MD

NPI 1548688989 · on the registry since 2014

Practice

Address
1055 N 500 W # 111
Provo, UT 84604
Phone
(801) 374-8999

Additional practice sites

  • 801 N 29th St, Billings, MT

Registry record

Primary taxonomy
MOHS-Micrographic Surgery Physician
207ND0101X
Also registered as
Dermatology Physician
MOHS-Micrographic Surgery Physician
MOHS-Micrographic Surgery Physician
Surgical Oncology Physician
Student in an Organized Health Care Education/Training Program
Licence states on file
MT, UT
From the registry's licence fields, which are often incomplete.
Sex
Male
Record last updated
2024-04-17
Status
Not present in the most recent federal file

Source: CMS National Plan and Provider Enumeration System. Registration is not the same as practising, and the registry records no retirement — some people listed here no longer practise. More in Utah