Provider Demographics
NPI:1063511855
Name:HAGLER, MARVIN S (CO)
Entity Type:Individual
Prefix:
First Name:MARVIN
Middle Name:S
Last Name:HAGLER
Suffix:
Gender:M
Credentials:CO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:49 MCDOWELL ST
Mailing Address - Street 2:
Mailing Address - City:ASHEVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28801-4103
Mailing Address - Country:US
Mailing Address - Phone:828-252-0331
Mailing Address - Fax:
Practice Address - Street 1:49 MCDOWELL ST
Practice Address - Street 2:
Practice Address - City:ASHEVILLE
Practice Address - State:NC
Practice Address - Zip Code:28801-4103
Practice Address - Country:US
Practice Address - Phone:828-252-0331
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-09-21
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes222Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOrthotist
Provider Identifiers
StateIdentifier IDID TypeIssuer
14317OtherPARTNERS
NC7701450Medicaid
0486MOtherBCBS
0938760001Medicare ID - Type Unspecified