Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 213ES0103X | Foot & Ankle Surgery | 206 | NC |
NPI | 1013913276 |
---|---|
Provider Name | Dr. Daniel M Hagan |
First Address | Jacksonville, NC 28540-8202 |
Second Address | Jacksonville, NC 28546-6351 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 22/06/2005 |
Last Update Date | 29/09/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
8908068 | (05) | NC |
T64069 | (02) | NC |