# ROBERT WILLIAM HAGEN M.D., INC.

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1316232150
- **Authorized official:** CHARLOTTE MARY HAGEN (VP)
- **Authorized official phone:** (208) 667-1110

## Contact information

- **Practice address:** 416 EAST COEUR D'ALENE AVENUE, COEUR D'ALENE, ID 83814
- **Practice address phone:** (208) 667-1110
- **Mailing address:** 416 EAST COEUR D'ALENE AVE., COEUR D'ALENE, ID 83814
- **Mailing address phone:** (208) 667-1110

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Q00000X | Family Medicine Physician | — | NULL | Yes |
| 207Q00000X | Family Medicine Physician | — | — | Yes |

## Other

- **Enumeration date:** 06/09/2011
- **Last updated:** 08/10/2011