Individual
HEATHER H HAGER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
1850 CHADWICK DR, JACKSON, MS 39204-3404
(601) 824-3977
(601) 376-1684
Mailing address
3675 J DEWEY GRAY CIR, SUITE 300, AUGUSTA, GA 30909-1868
(706) 863-9595
(706) 447-7120
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
R867584
MS
363L00000X
Nurse Practitioner
Primary
R867584
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01529099
—
MS
05
—
1036781
—
LA
01
—
302I500027
MEDICARE PTAN
MS
Enumeration date
01/02/2007
Last updated
02/11/2014
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