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Individual

JOHN C HAGOOD

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
R.PH., P.D.

Contact information

Practice address
909 N CEDAR ST, MEDICINE LODGE, KS 67104-1032
(620) 886-3275
(620) 886-5443
Mailing address
909 N CEDAR ST, P. O. BOX 367, MEDICINE LODGE, KS 67104-1032
(620) 886-3275
(620) 886-5443

Taxonomy

Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
1-09214
KS
183500000X
Pharmacist
PD12669
AR

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
1-09214
PHARMACIST
KS
01
PD12669
PHARMACIST
AR
Enumeration date
08/01/2016
Last updated
08/01/2016
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