Individual
DR. LEONARD SIMON FAGAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
10222 74TH STREET, SUITE 200, KENOSHA, WI 53142-6800
(262) 697-9200
(262) 697-9206
Mailing address
3301 W FOREST HOME AVE, MILWAUKEE, WI 53215-2843
(414) 389-2233
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
46372-020
WI
207V00000X
Obstetrics & Gynecology Physician
46372
WI
207V00000X
Obstetrics & Gynecology Physician
Primary
ME157114
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
34485700
—
WI
Enumeration date
09/23/2005
Last updated
10/03/2022
About Stedi
Stedi is the only programmable healthcare clearinghouse. You can use Stedi's APIs to process eligibility checks, claims, remits, and more.
Contact us