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NPI Code Detail

MEDICARE: MARK R HAGER MD

MEDICARE: MARK R HAGER 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
12084P0800XPsychiatry Physician941-526-6067SD

General Provider Information

NPI Number : 1952397499
Entity Type Code : Individual
Provider Name (Legal Business Name) : MARK R HAGER MD
Provider Business Mailing Address
First Line : 12979 387TH AVE
Second Line :
City : ABERDEEN
State : SD
Zip : 57401-8601
Country : US
Telephone Number : 605-250-1200
Fax Number :
Provider Business Practice Location Address
First Line : 379 6TH AVE W
Second Line :
City : BRADENTON
State : FL
Zip : 34205-8820
Country : US
Telephone Number : 941-782-4259
Fax Number : 941-782-4101
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/20/2005
Last Update Date : 09/08/2025

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