MEDICARE: DR. JOSE HAGAN M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207R00000X	Internal Medicine Physician	2006016403	MO
2	207RI0200X	Infectious Disease Physician	2006016403	MO

General Provider Information

NPI Number	:	1053438945
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JOSE HAGAN M.D.

Provider Business Mailing Address
First Line	:	1600 CLIFTON RD NE
Second Line	:
City	:	ATLANTA
State	:	GA
Zip	:	30329-4018
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	1600 CLIFTON RD NE
Second Line	:
City	:	ATLANTA
State	:	GA
Zip	:	30329-4018
Country	:	US
Telephone Number	:	800-232-4636
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/23/2007
Last Update Date	:	03/09/2026

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