# TYLER K HAGAN

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- **Entity:** Individual
- **Status:** Active
- **Sole proprietor:** No

## Provider details

- **NPI number:** 1588955231
- **Gender:** Man
- **Credential:** DPM

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 213EP1101X | Primary Podiatric Medicine Podiatrist | 617 | NC | — |
| 213ES0103X | Foot & Ankle Surgery Podiatrist | 617 | NC | Yes |
| 213ES0131X | Foot Surgery Podiatrist | 617 | NC | — |

## Other

- **Enumeration date:** 04/29/2011
- **Last updated:** 08/09/2022

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 1457601601 | GROUP NPI | NC |
| 01 | — | 1588955231 | INDIVIDUAL NPI | NC |
| 05 | — | 1720489818 | — | NC |