Healthcare Provider Details

I. General information

NPI: 1487641544
Provider Name (Legal Business Name): LEE ERIC HOAGLAND M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/04/2005
Last Update Date: 08/07/2025
Certification Date: 08/07/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

350 W COLUMBIA ST SUITE 420
EVANSVILLE IN
47710-1782
US

IV. Provider business mailing address

350 W COLUMBIA ST SUITE 420
EVANSVILLE IN
47710-1782
US

V. Phone/Fax

Practice location:
  • Phone: 812-422-3254
  • Fax: 812-426-6388
Mailing address:
  • Phone: 812-422-3254
  • Fax: 812-426-6388

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2085R0202X
TaxonomyDiagnostic Radiology Physician
License Number01050893A
License Number StateIN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: