Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.
JAKE FAGAN, MD
ActiveJAKE FAGAN, MD is a Obesity Medicine healthcare provider located in PROVO, Utah. NPI 1548688989 is currently active in the NPPES registry. Verify at CMS.
Obesity Medicine · PROVO, UT
Registration Details
- NPI Number
- 1548688989
- Provider Type
- Individual
- Gender
- Male
- NPI Issued
- Apr 2, 2014 (12.393017331057 yrs)
- Last Updated
- Apr 17, 2024
- Licenses
-
MED-PHYS-LIC-76211 (MT)MED-PHYS-LIC-76211 (MT)76211 (MT)MED-PHYS-LIC-76211 (MT)
Practice Information
- Address
-
1055 N 500 W # 111PROVO, UT, 846043305Browse UT providers · Browse ZIP 84604
- Phone
- 8013748999
- Primary Specialty
-
Obesity Medicine
207ND0101X
- Additional Specialty
- Obesity Medicine
- Additional Specialty
- Obesity Medicine
- Additional Specialty
- Surgical Oncology
- Additional Specialty
- Student (Health Education/Training)
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.