MEDICARE: FRANCES EDNA HAGAMAN 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	2084P0800X	Psychiatry Physician	009429	LA

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	:	1588773675
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	FRANCES EDNA HAGAMAN MD

Provider Business Mailing Address
First Line	:	748 ERIE ST
Second Line	:
City	:	SHREVEPORT
State	:	LA
Zip	:	71106-1814
Country	:	US
Telephone Number	:	318-861-2354
Fax Number	:

Provider Business Practice Location Address
First Line	:	2924 KNIGHT ST
Second Line	:	BUILDING 3 SUITE 350
City	:	SHREVEPORT
State	:	LA
Zip	:	71105-2415
Country	:	US
Telephone Number	:	318-862-3053
Fax Number	:	318-862-3080

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

Provider Enumeration Date	:	08/30/2006
Last Update Date	:	09/20/2011

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