Individual
DR. DAVID WILLIAM HAGEDORN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PH.D.
Contact information
Practice address
100 BREWSTER BLVD, NAVAL HOSPITAL - FAMILY MEDICINE, CAMP LEJEUNE, NC 28547
(910) 450-8805
(910) 353-1763
Mailing address
200 VALENCIA DRIVE, SUITE 109, JACKSONVILLE, NC 28546-7807
(910) 353-1760
(910) 353-1763
Taxonomy
Speciality
Code
Description
License number
State
103G00000X
Clinical Neuropsychologist
Primary
3745
NC
103TC0700X
Clinical Psychologist
1117
SC
103TC0700X
Clinical Psychologist
PY00003898
WA
103TC2200X
Clinical Child & Adolescent Psychologist
32594
TX
Other
Enumeration date
05/30/2007
Last updated
05/19/2011
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