Individual
CALLIE WILKES HAGAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
303 HARRIS INDUSTRIAL BLVD STE 3, VIDALIA, GA 30474-8854
(912) 537-9355
Mailing address
1706 KNOLLWOOD ST, VIDALIA, GA 30474-5454
(912) 326-4159
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
10722
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
10722
GA MEDICAL BOARD
GA
Enumeration date
10/07/2021
Last updated
12/29/2025
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