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NPI 1730162199

NPI 1730162199 : SCOTT A HAGA PAC : CINCINNATI, OH

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General NPI Number Information
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    NPI Number           |    1730162199
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    Entity Type          |    Individual 
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    Provider Name        |    SCOTT A HAGA PAC
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    Gender               |    Male 
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Dates
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    Enumeration Date     |    11/21/2005
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    Last Update Date     |    12/09/2025
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Provider Practice Location Address
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    Address Line         |    446 MORGAN ST 
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    City                 |    CINCINNATI
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    State                |    OH
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    Zip                  |    45206-2348
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    Country              |    US
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    Telephone            |    513-834-7063
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    Fax                  |    
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Provider Business Mailing Address
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    Address Line         |    4600 MONTGOMERY RD STE 400 
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    City                 |    CINCINNATI
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    State                |    OH
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    Zip                  |    45212-2600
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    Country              |    US
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    Telephone            |    
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    Fax                  |    
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Authorized Official
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    Title or Position    |    
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    Name                 |        
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    Credential           |    
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    Telephone            |    
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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    Taxonomy Code        |    363A00000X
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    Taxonomy Name        |    Physician Assistant
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    License Number       |    5601003638
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    License Number State |    MI
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Taxonomy #2
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    Taxonomy Code        |    363A00000X
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    Taxonomy Name        |    Physician Assistant
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    License Number       |    50.008262RX
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    License Number State |    OH
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