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Individual

DR. TERRY M. HAGAN

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
4010 DUPONT CIR STE 202, LOUISVILLE, KY 40207-4847
(502) 326-3011
(502) 324-4577
Mailing address
4010 DUPONT CIR STE 202, LOUISVILLE, KY 40207-4847
(502) 326-3011
(502) 324-4577

Taxonomy

Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
21595
KY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
64215957
KY
Enumeration date
10/20/2005
Last updated
07/29/2019
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