Dr. Gregory Brent Hagedorn
Optometrist Optomitrist - Corneal and Contact Lenses
1413 N Elm St Suite 102
Henderson
, Kentucky 42420-2768
Dr. Gregory Brent Hagedorn
Optometrist Optomitrist - Corneal and Contact Lenses
1413 N Elm St Suite 102
Henderson
, Kentucky 42420-2768
(270) 827-0757
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About
Features
Specialties
- Optometrist
- Optomitrist - Corneal and Contact Lenses
Languages spoken
- English
Location
First Address
- Dr. Gregory Brent Hagedorn
- Po Box 577
- Henderson, KY
- Zip : 42419-0577
- Fax : (270) 827-0757
- Phone : (270) 826-1500
Second Address
- Dr. Gregory Brent Hagedorn
- 1413 N Elm St Suite 102
- Henderson, KY
- Zip : 42420-2768
- Fax : (270) 827-0757
- Phone : (270) 826-1500
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Scope of Practice
| Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
|---|---|---|---|---|
| Y | 152W00000X | Optometrist | 1016DT | KY |
| N | 152WC0802X | Optomitrist - Corneal and Contact Lenses | 1016DT | KY |
National Provider Identifier
| NPI | 1316905169 |
|---|---|
| Provider Name | Dr. Gregory Brent Hagedorn |
| First Address | Henderson, KY 42419-0577 |
| Second Address | Henderson, KY 42420-2768 |
| Gender | M |
| NPI Entity type | Individual |
| Is Sole Proprietor | Yes |
| Is Organization Subpart | N/A |
| Enumeration Date | 02/05/2006 |
| Last Update Date | 22/07/2014 |
Additional Identifiers
| IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
|---|---|---|
| 77010163 | (05) | KY |
| T54728 | (02) | KY |
NPI Footnotes
What is the National Provider Identifier (NPI)
Provider Location Address
Provider Mailing Address
Entity Type Code
1= Person: individual human being who furnishes health care;
2= Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)
What is a Subpart?
Provider Other Organization Name
1 = former name;
2 = professional name;
3 = doinq business as (d/b/ a) name;
4 = former legal business name;
5 = other.