Individual
LISA ANN HAGLUND
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
3223 EDEN & ALBERT SABIN, # 405, CINCINNATI, OH 45267-0405
(513) 584-6868
(513) 584-6040
Mailing address
PO BOX 636256, CENTRAL CREDENTIALING, CINCINNATI, OH 45263-6256
(513) 585-5504
(513) 585-5511
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
35-062037
OH
207RI0200X
Infectious Disease Physician
Primary
35-062037
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0861812
—
OH
05
—
200120010
—
IN
01
—
440000804
RAIL ROAD MEDICARE
OH
05
—
64868003
—
KY
Enumeration date
04/21/2006
Last updated
08/10/2017
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