Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Timothy D Fagen, DO

Individual provider General Practice Physician · NPI 1750315958

Timothy D Fagen, DO is a General Practice Physician in Saint Louis, Missouri. Licensed in Hawaii, Michigan and Missouri. Registered with an NPI since 2006.

Licensed in
HI, MI, MO
In the registry since
2006
Specialties on file
3
What do these letters mean?
DO — Doctor of Osteopathic Medicine
A fully licensed physician, trained like an MD with additional musculoskeletal training. Equivalent practice rights in all 50 states.

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Practice location Address checks out

1402 S Grand Blvd Ste M260 ST Louis University Gme
Saint Louis, MO 63104-1004
Phone: (314) 577-8782
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Anatomic Pathology & Clinical Pathology Physician (primary) Taxonomy 207ZP0102X · Licence 2010014000 (MO)
General Practice Physician Taxonomy 208D00000X · Licence 5101017047 (MI)
General Practice Physician Taxonomy 208D00000X · Licence DOS 1120 (HI)

Record details

NPI number1750315958
Entity typeIndividual (Type 1)
GenderMale
Credentials DO
Sole proprietorNo
NPI enumeratedJuly 11, 2006
Last updated in NPPESAugust 11, 2010

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