Organization
ROY O FAGAN III MD PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ROY O FAGAN MD (PRESIDENT)
(336) 342-4448
Entity
Organization
Contact information
Practice address
419 W HARRISON ST, REIDSVILLE, NC 27320-5015
(336) 342-4448
(336) 342-4499
Mailing address
419 W HARRISON ST, REIDSVILLE, NC 27320-5015
(336) 342-4448
(336) 342-4499
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
37825
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
7931038
—
NC
Enumeration date
12/11/2007
Last updated
12/11/2007
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