MEDICARE: SCOTT HAGLUND

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	247100000X	Radiologic Technologist	354637	MN
2	405300000X	Prevention Professional	1415	MN

General Provider Information

NPI Number	:	1316471253
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SCOTT HAGLUND

Provider Business Mailing Address
First Line	:	7633 BENNETT CT
Second Line	:
City	:	INVER GROVE HEIGHTS
State	:	MN
Zip	:	55077-3221
Country	:	US
Telephone Number	:	612-749-3809
Fax Number	:

Provider Business Practice Location Address
First Line	:	7633 BENNETT CT
Second Line	:
City	:	INVER GROVE HEIGHTS
State	:	MN
Zip	:	55077-3221
Country	:	US
Telephone Number	:	612-749-3809
Fax Number	:

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

Provider Enumeration Date	:	04/18/2017
Last Update Date	:	04/18/2017

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Directions to “ SCOTT HAGLUND ” Practice Location

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