Individual
DR. SHELTON HAGER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
105 W STONE DR, STE 3A, KINGSPORT, TN 37660-3256
(423) 392-6200
(423) 392-6593
Mailing address
PO BOX 9, KINGSPORT, TN 37662-0009
(423) 857-2066
(423) 857-2070
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
39196
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
10134706
—
VA
05
—
3325584
—
TN
Enumeration date
05/31/2005
Last updated
09/16/2019
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