Individual
DR. DAVID JOHN HAGAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
222 N SANGAMON AVE, GIBSON CITY, IL 60936-1345
(217) 784-8148
(217) 784-8160
Mailing address
1120 N MELVIN ST, GIBSON CITY, IL 60936-1477
(217) 784-8148
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
036066538
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
143882
RIVERBEND MEDICARE
—
01
—
2715526
BCBS
—
Enumeration date
11/07/2005
Last updated
08/11/2020
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