Individual
DR. PAUL ANTHONY FAGAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
855 N WESTHAVEN DR, OSHKOSH, WI 54904-7668
(920) 303-8700
(920) 303-8801
Mailing address
855 N WESTHAVEN DR, OSHKOSH, WI 54904-7668
(920) 303-8700
(920) 303-8801
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
5101018111
MI
207X00000X
Orthopaedic Surgery Physician
Primary
63870-021
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100046679
—
WI
Enumeration date
05/14/2009
Last updated
12/08/2023
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