About Jake Fagan
He is located at 1055 N 500 W # 111, Att Credentialing, in Provo, UT 84604. Appointment can be made via the phone number (801) 374-8999.
Jake Fagan - Address, Phone & Website
1055 N 500 W # 111, Att Credentialing, Provo, UT 84604
(801) 374-8999
Medical Specialties & Taxonomy codes
Jake Fagan is a board-certified physician with expertise in multiple areas of medicine, including , MOHS-Micrographic Surgery, MOHS-Micrographic Surgery, Surgical Oncology and . Below is the official taxonomy classification for these specialties.| Primary | Specialty | Taxonomy Code |
|---|---|---|
| No | Dermatology Physician | 207N00000X |
| No | MOHS-Micrographic Surgery Physician | 207ND0101X |
| No | MOHS-Micrographic Surgery Physician | 207ND0101X |
| No | Surgical Oncology Physician | 2086X0206X |
| No | Student in an Organized Health Care Education/Training Program | 390200000X |
Licenses
| State | License Number |
|---|---|
| Montana | MED-PHYS-LIC-76211 |
| Montana | 76211 |
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