MEDICARE: DR. DANIEL M HAGAN DPM

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	2083P0011X	Undersea and Hyperbaric Medicine (Preventive Medicine) Physician	206	NC
2	213ES0103X	Foot & Ankle Surgery Podiatrist	206	NC

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1013913276
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. DANIEL M HAGAN DPM

Provider Business Mailing Address
First Line	:	1404 CLIFTON RD
Second Line	:
City	:	JACKSONVILLE
State	:	NC
Zip	:	28540-8202
Country	:	US
Telephone Number	:	910-382-7424
Fax Number	:	910-346-3303

Provider Business Practice Location Address
First Line	:	237 WHITE ST STE 2
Second Line	:
City	:	JACKSONVILLE
State	:	NC
Zip	:	28546-6351
Country	:	US
Telephone Number	:	910-577-4977
Fax Number	:	910-577-4980

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/22/2005
Last Update Date	:	09/29/2021

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