Individual
JARITA ARNETTE HAGANS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
9000 WOODYARD RD, CLINTON, MD 20735-4206
(240) 546-3428
Mailing address
5000 COX RD, GLEN ALLEN, VA 23060-9263
(804) 968-5700
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
D0074806
MD
207Q00000X
Family Medicine Physician
MD202449
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
APPLIED
MEDICARE AND MEDICAID HAVE BEEN APPLIED FOR
LA
Enumeration date
08/29/2008
Last updated
06/24/2021
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