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General NPI Number Information
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NPI Number | 1497946974
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Entity Type | Organization
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Legal Business Name | MARION L. HAGAN M.D.
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Dates
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Enumeration Date | 08/08/2007
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Last Update Date | 08/08/2007
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Provider Practice Location Address
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Address Line | 567 S MAPLE ST
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City | FRENCH LICK
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State | IN
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Zip | 47432-2245
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Country | US
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Telephone | 812-936-4515
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Fax | 812-936-4536
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Provider Business Mailing Address
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Address Line | 567 S MAPLE ST
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City | FRENCH LICK
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State | IN
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Zip | 47432-2245
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Country | US
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Telephone | 812-936-4515
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Fax | 812-936-4536
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Authorized Official
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Title or Position | PHYSICIAN/ OWNER
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Name | DR. MARION L. HAGAN
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Credential | M.D.
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Telephone | 812-936-4515
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 01019427
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License Number State | IN
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