Healthcare Provider Details

I. General information

NPI: 1285606483
Provider Name (Legal Business Name): GERALD D HAGIN M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/02/2006
Last Update Date: 03/18/2022
Certification Date: 03/18/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2070 W RUDASILL RD STE 130
TUCSON AZ
85704-7891
US

IV. Provider business mailing address

PO BOX 910221
DALLAS TX
75391-0221
US

V. Phone/Fax

Practice location:
  • Phone: 520-797-4468
  • Fax: 520-797-4502
Mailing address:
  • Phone: 520-519-7700
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207RH0003X
TaxonomyHematology & Oncology Physician
License Number10570
License Number StateAZ
# 2
Primary TaxonomyY
Taxonomy Code207RX0202X
TaxonomyMedical Oncology Physician
License Number10570
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: