Provider Demographics
NPI:1336118934
Name:HAGES, RICHARD JOSEPH JR (DC, CCSP)
Entity Type:Individual
Prefix:DR
First Name:RICHARD
Middle Name:JOSEPH
Last Name:HAGES
Suffix:JR
Gender:M
Credentials:DC, CCSP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6601 VETERANS MEMORIAL BLVD
Mailing Address - Street 2:#39
Mailing Address - City:METAIRIE
Mailing Address - State:LA
Mailing Address - Zip Code:70003-3943
Mailing Address - Country:US
Mailing Address - Phone:504-455-4302
Mailing Address - Fax:504-455-7800
Practice Address - Street 1:6601 VETERANS MEMORIAL BLVD
Practice Address - Street 2:#39
Practice Address - City:METAIRIE
Practice Address - State:LA
Practice Address - Zip Code:70003-3943
Practice Address - Country:US
Practice Address - Phone:504-455-4302
Practice Address - Fax:504-455-7800
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-03-16
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA269111NS0005X
AL767111NS0005X
FL5601111NS0005X
CO2852111NS0005X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111NS0005XChiropractic ProvidersChiropractorSports Physician
Provider Identifiers
StateIdentifier IDID TypeIssuer
LAT19962Medicare UPIN
LA59176Medicare ID - Type Unspecified