Individual
MS. SUSAN E HAGAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
1000 NEIGHBORHOOD PL, FAIRDALE, KY 40118-9697
(502) 361-2381
(502) 996-8309
Mailing address
PO BOX 950244, LOUISVILLE, KY 40295-0244
(502) 953-4700
(502) 772-8189
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
01092149A
IN
207V00000X
Obstetrics & Gynecology Physician
Primary
40340
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000596343
ANTHEM - WS
KY
01
—
000023034S
HUMANA - WS
KY
01
—
00533083
MEDICARE - WSP
KY
01
—
100205
SIHO - WS
KY
05
—
200941180
—
IN
05
—
2691930
—
OH
01
—
50021335
PASSPORT - WS
KY
05
—
64125552
—
KY
01
—
P00912082
RAILROAD MEDICARE
KY
Enumeration date
08/31/2006
Last updated
02/28/2025
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