Individual
TYLER K HAGAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DPM
Contact information
Practice address
612A MCCARTHY BLVD, NEW BERN, NC 28562-5231
(252) 633-3400
(252) 633-9338
Mailing address
612A MCCARTHY BLVD, NEW BERN, NC 28562-5231
(252) 633-3400
(252) 633-9338
Taxonomy
Speciality
Code
Description
License number
State
213EP1101X
Primary Podiatric Medicine Podiatrist
617
NC
213ES0103X
Foot & Ankle Surgery Podiatrist
Primary
617
NC
213ES0131X
Foot Surgery Podiatrist
617
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1457601601
GROUP NPI
NC
01
—
1588955231
INDIVIDUAL NPI
NC
05
—
1720489818
—
NC
Enumeration date
04/29/2011
Last updated
08/09/2022
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