MEDICARE: DR. JONATHAN TAYLOR HAGEN MD

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	207X00000X	Orthopaedic Surgery Physician	A148997	CA
2	207X00000X	Orthopaedic Surgery Physician	17021	NV

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1487915153
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JONATHAN TAYLOR HAGEN MD

Provider Business Mailing Address
First Line	:	1111 EMERALD BAY RD
Second Line	:
City	:	SOUTH LAKE TAHOE
State	:	CA
Zip	:	96150-6207
Country	:	US
Telephone Number	:	530-543-5659
Fax Number	:	530-541-8723

Provider Business Practice Location Address
First Line	:	212 ELKS POINT RD STE 200
Second Line	:
City	:	ZEPHYR COVE
State	:	NV
Zip	:	89448-8001
Country	:	US
Telephone Number	:	775-589-8950
Fax Number	:	775-588-1299

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

Provider Enumeration Date	:	05/30/2012
Last Update Date	:	07/21/2022

Similar Medicare Providers

1255330312 — DR. KEITH ROBERT SWANSON MD
Practice Location Address:

212 ELKS POINT RD , STE 200
ZEPHYR COVE, NV
89448-8001

Practice Phone: 775-589-8950
Practice Fax: 775-588-1299

1639181506 — SAFEWAY INC
Practice Location Address:

212 ELKS POINT RD
ZEPHYR COVE, NV
89448-8001

Practice Phone: 775-586-1088
Practice Fax: 775-586-9019

1700963725 — BARTON HEALTHCARE SYSTEM
Practice Location Address:

212 ELKS POINT RD , SUITE 201
ZEPHYR COVE, NV
89448-8001

Practice Phone: 775-588-9188
Practice Fax: 775-588-4337

1609937911 — LAKE TAHOE ORTHOPAEDIC INSTITUTE, A WATSON-SWANSON PROFESSIONAL CORP
Practice Location Address:

212 ELKS POINT RD STE 200
ZEPHYR COVE, NV
89448-8001

Practice Phone: 775-589-8950
Practice Fax: 775-588-1299

1093051104 — SAFEWAY PHARMACY
Practice Location Address:

212 ELKS POINT RD
ZEPHYR COVE, NV
89448-8001

Practice Phone: 775-586-1088
Practice Fax:

1962835629 — MR. MIKEL SCOTT ASHBY RPH
Practice Location Address:

212 ELKS POINT RD
ZEPHYR COVE, NV
89448-8001

Practice Phone: 775-586-1088
Practice Fax: 775-586-9019

Directions to “ DR. JONATHAN TAYLOR HAGEN MD” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.