Individual
DR. GEORGE H HAGEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
O.D.
Contact information
Practice address
1114 E MAIN ST, TRINIDAD, CO 81082-2034
(719) 846-7342
(719) 846-4041
Mailing address
1114 E MAIN ST, TRINIDAD, CO 81082-2034
(719) 846-7342
(719) 846-4041
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
835
CO
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
332H00000X
Eyewear Supplier
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
08008351
—
CO
Enumeration date
09/29/2006
Last updated
05/08/2008
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