Provider Demographics
NPI:1437275864
Name:KAGAN, JAMES MELVIN (MD)
Entity Type:Individual
Prefix:DR
First Name:JAMES
Middle Name:MELVIN
Last Name:KAGAN
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:2629 REDWING RD
Mailing Address - Street 2:SUITE 295
Mailing Address - City:FORT COLLINS
Mailing Address - State:CO
Mailing Address - Zip Code:80526-6315
Mailing Address - Country:US
Mailing Address - Phone:970-223-5125
Mailing Address - Fax:970-282-0015
Practice Address - Street 1:2629 REDWING RD
Practice Address - Street 2:SUITE 295
Practice Address - City:FORT COLLINS
Practice Address - State:CO
Practice Address - Zip Code:80526-6315
Practice Address - Country:US
Practice Address - Phone:970-223-5125
Practice Address - Fax:970-282-0015
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-21
Last Update Date:2007-07-08
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
CO192752084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO01192756Medicaid