MEDICARE: DR. THOMAS JAMES 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	213E00000X	Podiatrist	137	NC
2	213ES0103X	Foot & Ankle Surgery Podiatrist	137	NC
3	213EP1101X	Primary Podiatric Medicine Podiatrist	137	NC

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	1457601601	OTHER	NC	GROUP NPI
2	1962406991	OTHER	NC	INDIVIDUAL NPI

General Provider Information

NPI Number	:	1962406991
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. THOMAS JAMES HAGAN DPM

Provider Business Mailing Address
First Line	:	612A MCCARTHY BLVD
Second Line	:
City	:	NEW BERN
State	:	NC
Zip	:	28562-5231
Country	:	US
Telephone Number	:	252-633-3400
Fax Number	:	252-633-9338

Provider Business Practice Location Address
First Line	:	612A MCCARTHY BLVD
Second Line	:
City	:	NEW BERN
State	:	NC
Zip	:	28562-5231
Country	:	US
Telephone Number	:	252-633-3400
Fax Number	:	252-633-9338

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

Provider Enumeration Date	:	06/08/2005
Last Update Date	:	08/09/2022

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