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Contact Information

THOMAS W FAGG, DO
1002 LINCOLN WAY
JEFFERSON, IA50129
 Phone: 515-386-4192
 Fax: 515-386-3448
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Family Medicine

207Q00000X 08 Physician/Family Practice
Indicates primary specialty

NPI Profile & details for THOMAS W FAGG · (Male)

NPI # 1235127481
Status Active
Credentials DO (Doctor of Osteopathic)
Entity Individual
Enumeration date 10/12/2005
Last updated 05/16/2008 - About 18 years ago
Sole proprietor 1 No
Identifiers
  • IA License # 02388
  • IA Medicaid 0074856
Hospital affiliation(s)
  • GREENE COUNTY MEDICAL CENTER - (Critical Access)
    1000 WEST LINCOLNWAY
    JEFFERSON, IA 50129
  • ST ANTHONY REGIONAL HOSPITAL & NURSIING HOME - (Acute Care)
    311 SOUTH CLARK STREET
    CARROLL, IA 51401
  • STEWART MEMORIAL COMMUNITY HOSPITAL - (Critical Access)
    1301 WEST MAIN STREET
    LAKE CITY, IA 51449
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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