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General NPI Number Information
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NPI Number | 1497558795
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Entity Type | Organization
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Legal Business Name | MARK L HAGOOD MD LLC
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Dates
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Enumeration Date | 03/31/2025
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Last Update Date | 03/31/2025
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Provider Practice Location Address
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Address Line | 5768 HIGHWAY 431 S
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City | BROWNSBORO
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State | AL
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Zip | 35741-9775
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Country | US
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Telephone | 256-693-6863
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Fax | 800-506-4139
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Provider Business Mailing Address
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Address Line | 239 S GREEN MOUNTAIN RD
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City | OWENS CROSS ROADS
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State | AL
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Zip | 35763-9012
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Country | US
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Telephone | 256-509-5547
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Fax |
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Authorized Official
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Title or Position | PHYSICIAN/PRESIDENT
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Name | DR. MARK LESTER HAGOOD
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Credential | MD
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Telephone | 256-693-6863
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Y00000X
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Taxonomy Name | Otolaryngology Physician
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License Number |
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License Number State |
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