Individual
RONALD A HAGEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3039410
—
TN
01
—
4061498
BCBS PROVIDER
—
01
—
P00078046
RAILROAD MEDICARE
—
Enumeration date
01/26/2006
Last updated
01/23/2008
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