Organization
WAYNE T HAGERMAN OD PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
GRETA L RYAN (CLERK)
(907) 747-6644
Entity
Organization
Contact information
Practice address
700 KATLIAN ST STE C, SITKA, AK 99835-7314
(907) 747-6644
(907) 747-4990
Mailing address
700 KATLIAN ST STE C, SITKA, AK 99835-7314
(907) 747-6644
(907) 747-4990
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
AK055
AK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
AK55
—
AK
05
—
OP0055
—
AK
Enumeration date
05/14/2010
Last updated
08/03/2011
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