# TYLER K. HAGAN, DPM, PLLC

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

## Provider details

- **NPI number:** 1720489818
- **Authorized official:** TYLER K HAGAN DPM (SOLE MEMBER)
- **Authorized official phone:** (252) 633-3400

## Contact information

- **Practice address:** 612A MCCARTHY BLVD, NEW BERN, NC 28562-5231
- **Practice address phone:** (252) 633-3400
- **Practice address fax:** (252) 633-9338
- **Mailing address:** 612A MCCARTHY BLVD, NEW BERN, NC 28562-5231
- **Mailing address phone:** (252) 633-3400
- **Mailing address fax:** (252) 633-9338

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 213E00000X | Podiatrist | 617 | NC | — |
| 213ES0103X | Foot & Ankle Surgery Podiatrist | 617 | NC | Yes |
| 213ES0131X | Foot Surgery Podiatrist | 617 | NC | — |

## Other

- **Enumeration date:** 09/09/2014
- **Last updated:** 12/04/2014

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 1588955231 | INDIVIDUAL NPI | NC |