Individual
SAMUEL LYLE HAGUE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1009 W FERGUSON AVE, BLACKWELL, OK 74631-5602
(580) 363-0052
(580) 363-0894
Mailing address
1009 W FERGUSON AVE, BLACKWELL, OK 74631-5602
(580) 363-0052
(580) 363-0894
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
22530
OK
Other
Enumeration date
06/22/2005
Last updated
03/25/2008
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