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Jason Fagan
NPI 1730377219 · on the registry since 2007 · sole proprietor
Practice
- Address
- 405 Orchard Rd
Elizabethton, TN 37643 - Phone
- (423) 342-6177
Registry record
- Primary taxonomy
- 164W00000X
164W00000X
- Licence states on file
- TN
From the registry's licence fields, which are often incomplete.
- Sex
- Male
- Record last updated
- 2007-10-09
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 Tennessee