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Individual

JAMES PATRICK FOGARTY

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
902 WEST MAIN STREET, CAMERON, WI 54822-0144
(715) 458-3124
(715) 458-3125
Mailing address
P.O. BOX 144, CAMERON, WI 54822-0144
(715) 458-3124
(715) 458-3125

Taxonomy

Speciality
Code
Description
License number
State
208600000X
Surgery Physician
18691
WI
363L00000X
Nurse Practitioner
Primary
1673
WI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
21288500
WI
Enumeration date
09/15/2005
Last updated
09/19/2024
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