MCCALL FAGAN (NPI# 1528052289) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1528052289 |
Entity Type | Individual |
Full Name | MCCALL FAGAN |
Credential | PA-C |
Practice Address |
5323 South Woodrow Street Suite 200 Murray UT 84107 |
Practice Telephone | 8017471020 |
Practice Fax Number | 8017471023 |
Mailing Telephone | 8017471020 |
Mailing Fax Number | 8017471023 |
Enumeration Date | 2005-09-08 |
Last Update Date | 2008-12-10 |
Gender Code | F |
Is Sole Proprietor | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 363AS0400X |
Physician Assistant Specialization: Surgical Technologist |
5256821-1206 | UT | Physician Assistants & Advanced Practice Nursing Providers |
Street Address |
5323 SOUTH WOODROW STREET SUITE 200 |
City | MURRAY |
State | UT |
Zip Code | 84107 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1104000637 | Allen R Groebs Md PC | Orthopaedic Surgery | 5323 South Woodrow Street, Suite 200, Murray, UT 84107 | 2007-12-19 |
1295919728 | Brian W Fukushima Md PC | Orthopaedic Surgery | 5323 South Woodrow Street, Suite 200, Murray, UT 84107 | 2007-12-19 |
1114101649 | Justin P Hawes Md PC | Orthopaedic Surgery | 5323 South Woodrow Street, Suite 200, Murray, UT 84107 | 2007-12-19 |
1164453106 | Stephen Warner | Orthopaedic Surgery | 5323 South Woodrow Street, Suite 200, Murray, UT 84107 | 2006-07-06 |
1508896226 | Justin P Hawes | Orthopaedic Surgery | 5323 South Woodrow Street, Suite 200, Murray, UT 84107 | 2006-07-05 |
1841228905 | Allen R Groebs | Orthopaedic Surgery | 5323 South Woodrow Street, Suite 200, Murray, UT 84107 | 2006-06-29 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1902410517 | Brielle Nicole Poulter | Student in an Organized Health Care Education/Training Program | 345 East 4500 So #260, Murray, UT 84107 | 2020-09-01 |
1467016592 | Ashlee Brown | Social Worker | C-134, 5284 Commerce Drive, Murray, Murray, UT 84107 | 2019-04-24 |
1568940633 | Samantha Duff | Occupational Therapist | 5770 S Fashion Blvd, Bldg 5 Ste 201, Murray, UT 84107 | 2018-08-01 |
1881185247 | Derek John Sharp | Occupational Therapist | 5770 S Fashion Blvd, Bldg #5, Suite 210, Murray, UT 84107 | 2018-05-22 |
1093223091 | Erin Nicole Hill | Counselor | 345 East 4500 South Suite 260, Murray, UT 84107 | 2018-01-12 |
1588171219 | Nicole Danielle Jensen | Counselor | 345 East 4500 South, Suite 260, Murray, UT 84107 | 2018-01-03 |
1043725799 | Greater Endodontics LLC | Dentist | 5334 South Woodrow Street, Suite 201, Salt Lake City, UT 84107 | 2017-12-04 |
1043739667 | Karyn K Hodge | Audiologist | 4500 So. 777. E. Ste #110, Murray, UT 84107 | 2017-09-14 |
1912426750 | Brandon C Burton | Specialist/Technologist, Other | Cta Community Supports 4444 S, 700 E Suite 203, Salt Lake City, UT 84107 | 2017-09-13 |
1396261152 | Megan Lehane Delano | Plastic Surgery | 5169 Cottonwood St Ste 420, Murray, UT 84107 | 2017-08-14 |
Find all providers in zip 84107 |
Taxonomy Code | 363AS0400X |
Grouping | Physician Assistants & Advanced Practice Nursing Providers |
Classification | Physician Assistant |
Specialization | Surgical Technologist |
Definition to come... |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1891230041 | Sarah Danielle Mendenhall | Physician Assistant | 5169 S Cottonwood St Ste 600, Murray, UT 84107-6771 | 2016-12-26 |
1982869210 | Scott D Taylor | Physician Assistant | 5323 Woodrow St Ste 102, Murray, UT 84107-5853 | 2008-07-25 |
1154315521 | Lorie Lee | Physician Assistant | 5848 Fashion Blvd, Murray, UT 84107-6121 | 2005-08-31 |
1366877029 | Robert Chad Bannon | Physician Assistant | 5121 S Cottonwood St, Ste 950, Murray, UT 84107-5701 | 2013-09-12 |
1295071801 | Jason Holden | Physician Assistant | 5848 S Fashion Blvd, Murray, UT 84107-6121 | 2012-12-31 |
1083917355 | John Dudley Duross | Physician Assistant | 5121 South Cottonwood Street, Murray, UT 84157 | 2010-12-08 |
1154639276 | Kristi Reinschmidt | Physician Assistant | 5169 Cottonwood St, Suite 320, Murray, UT 84107-6767 | 2010-09-23 |
1568773935 | Amanda Dunn | Physician Assistant | 5770 S 250 E Ste 285, Murray, UT 84107-8194 | 2010-06-30 |
1821240243 | Joseph Lawrence Sartori | Physician Assistant | 5444 Green St, Murray, UT 84123-5632 | 2008-10-16 |
1710098058 | James G Rowley | Physician Assistant | 5848 Fashion Blvd, Murray, UT 84107-6121 | 2006-08-31 |
Find all providers in MURRAY |
Please comment or provide details below to improve the information on MCCALL FAGAN.
Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.