Individual
KENTON LEE HAGAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
3900 N PARKVIEW DR, FAYETTEVILLE, AR 72703-6398
(479) 966-4187
(479) 966-4197
Mailing address
3900 N PARKVIEW DR, FAYETTEVILLE, AR 72703-6398
(479) 966-4187
(479) 966-4197
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
E-12883
AR
Other
Enumeration date
04/02/2015
Last updated
09/15/2020
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