Individual
SHANE D GAGON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
377 N FAIRGROUNDS RD, PRICE, UT 84501-4208
(435) 613-2200
(435) 613-2201
Mailing address
PO BOX 1437, PRICE, UT 84501-1437
(435) 613-2200
(435) 613-2201
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
361555-1205
UT
Other
Enumeration date
10/04/2006
Last updated
12/31/2021
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