Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207XX0004X | Foot and Ankle Orthopaedic Surgeon | 0101238696 | VA |
NPI | 1235171406 |
---|---|
Provider Name | Dr. Mark Lindsay Hagy |
First Address | Roanoke, VA 24014-0310 |
Second Address | Salem, VA 24153-7304 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 12/06/2006 |
Last Update Date | 31/08/2020 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
010200601 | (05) | VA |
185348 | ANTHEM (01) | VA |
2140840 | MAMSI (01) | VA |
332136 | SOUTHERN HEALTH (01) | VA |
393326001 | ADMINISTAR FEDERAL (01) | VA |
542006922 | UNITED HEALTHCARE (01) | VA |
7849752 | AETNA (01) | VA |
8150571 | CIGNA (01) | VA |
I37634 | (02) | VA |