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Jake Fagan, MD
MOHS-Micrographic Surgery Physician in Provo, Utah
NPI 1548688989

Jake Fagan is a MOHS-Micrographic Surgery Physician based in Provo, UT and is specialized in MOHS-Micrographic Surgery. Jake Fagan practices in Provo, UT and has the professional credentials of MD. The NPI Number for Jake Fagan is 1548688989 and holds a License No. MED-PHYS-LIC-76211 (Utah).

The current practice location address for Jake Fagan is 1055 N 500 W # 111, Provo, UT and can be reached out via phone at 801-374-8999.

Location: 1055 N 500 W # 111, Provo, UT, 84604
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1548688989
Provider Name
Jake Fagan
Credential
MD
Provider Entity Type
Individual
Gender
Male
Address
1055 N 500 W # 111, Provo, UT, 84604
Phone Number
801-374-8999
Fax Number
Provider Enumeration Date
04/02/2014
Last Update Date
05/18/2024
institution
Provider Business Practice Location Address Details
Address
1055 N 500 W # 111
City
Provo
State
Utah
Zip
84604-3305
Phone Number
801-374-8999
Fax Number
person
Provider Business Mailing Address Details
Address
1055 N 500 W # 111
City
Provo
State
Utah
Zip
84604-3305
Phone Number
801-374-8999
Fax Number
person
Provider's Taxonomy Details 1
Type
Allopathic & Osteopathic Physicians
Classification
Dermatology
Speciality
-
Taxonomy
207N00000X
License No.
MED-PHYS-LIC-76211 (Montana)
Definition
A dermatologist is trained to diagnose and treat pediatric and adult patients with benign and malignant disorders of the skin, mouth, external genitalia, hair and nails, as well as a number of sexually transmitted diseases. The dermatologist has had additional training and experience in the diagnosis and treatment of skin cancers, melanomas, moles and other tumors of the skin, the management of contact dermatitis and other allergic and nonallergic skin disorders, and in the recognition of the skin manifestations of systemic (including internal malignancy) and infectious diseases. Dermatologists have special training in dermatopathology and in the surgical techniques used in dermatology. They also have expertise in the management of cosmetic disorders of the skin such as hair loss and scars and the skin changes associated with aging.
person
Provider's Taxonomy Details 2
Type
Allopathic & Osteopathic Physicians
Classification
Dermatology
Speciality
MOHS-Micrographic Surgery
Taxonomy
207ND0101X
License No.
76211 (Montana)
Definition
The highly-trained surgeons that perform Mohs Micrographic Surgery are specialists both in dermatology and pathology. With their extensive knowledge of the skin and unique pathological skills, they are able to remove only diseased tissue, preserving healthy tissue and minimizing the cosmetic impact of the surgery. Mohs surgeons who belong to the American College of Mohs Surgery (ACMS) have completed a minimum of one year of fellowship training at one of the ACMS-approved training centers in the U.S.
person
Provider's Taxonomy Details 3
Type
Allopathic & Osteopathic Physicians
Classification
Surgery
Speciality
Surgical Oncology
Taxonomy
2086X0206X
License No.
MED-PHYS-LIC-76211 (Montana)
Definition
A surgical oncologist is a well-qualified surgeon who has obtained additional training and experience in the multidisciplinary approach to the prevention, diagnosis, treatment, and rehabilitation of cancer patients, and devotes a major portion of his or her professional practice to these activities and cancer research.
person
Provider's Taxonomy Details 4
Type
Student, Health Care
Classification
Student in an Organized Health Care Education/Training Program
Speciality
-
Taxonomy
390200000X
License No.
MED-PHYS-LIC-76211 (Montana)
Definition
An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.
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