Individual
DR. LARRY LYNN HAGAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
207KA0200X
Allergy Physician
Primary
22558
WV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0011693000
—
WV
05
—
3810007713
—
WV
05
—
L2725779
—
OH
Enumeration date
06/06/2006
Last updated
09/27/2007
Update your record
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