Individual
DR. THOMAS W. FAGG
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
1002 LINCOLN WAY, JEFFERSON, IA 50129
(515) 386-4192
(515) 386-3448
Mailing address
1002 LINCOLN WAY, JEFFERSON, IA 50129
(515) 386-4192
(515) 386-3448
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
02388
IA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0074856
—
IA
Enumeration date
10/12/2005
Last updated
05/16/2008
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