Individual
DR. ROY O FAGAN III
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
419 W HARRISON ST, REIDSVILLE, NC 27320
(336) 342-4448
(336) 342-4499
Mailing address
PO BOX 2123, REIDSVILLE, NC 27323
(336) 342-4448
(336) 342-4499
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
130425
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
7931038
—
NC
Enumeration date
05/01/2006
Last updated
05/30/2013
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