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Organization

DR. GREGORY B. HAGEDORN, OD

Active
Other names
Gregory B Hagedorn
Organization subpart
No

Provider details

NPI number
Authorized official
DR. GREGORY BRENT HAGEDORN OD (DOCTOR)
(270) 826-1500
Entity
Organization

Contact information

Practice address
1413 N ELM ST, SUITE 102, HENDERSON, KY 42420-2768
(270) 826-1500
(270) 827-0757
Mailing address
1413 N ELM ST, SUITE 102, HENDERSON, KY 42420-2768
(270) 826-1500
(270) 827-0757

Taxonomy

Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
1016DT
KY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
77010163
KY
Enumeration date
03/05/2012
Last updated
03/05/2012
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