Individual
JASON D HAGEMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1800 E 5TH ST STE 1, DELPHOS, OH 45833-9180
(419) 692-5611
(419) 695-9401
Mailing address
PO BOX 636930, CINCINNATI, OH 45263-6930
(513) 981-5123
(513) 981-5015
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
35.098971
OH
207QS0010X
Sports Medicine (Family Medicine) Physician
35.098971
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0106330
OH MEDICAID
OH
01
—
H336690
OH MEDICARE
OH
Enumeration date
05/13/2010
Last updated
12/15/2017
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