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Individual

DR. DAVID G FAGAN

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
11 MEDICAL PARK, VALLEY, AL 36854-3665
(334) 756-4860
(334) 756-4866
Mailing address
510 AZALEA DRIVE, LANETT, AL 36863
(334) 644-3492

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
00017725
AL

Other

Enumeration date
07/24/2006
Last updated
12/06/2007
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