Provider Demographics
NPI:1386660231
Name:HAGAN, THOMAS JAMES (SA-C)
Entity Type:Individual
Prefix:
First Name:THOMAS
Middle Name:JAMES
Last Name:HAGAN
Suffix:
Gender:M
Credentials:SA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3301 NEW HOPE RD
Mailing Address - Street 2:
Mailing Address - City:HENDERSONVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37075-8619
Mailing Address - Country:US
Mailing Address - Phone:615-824-0978
Mailing Address - Fax:
Practice Address - Street 1:3301 NEW HOPE RD
Practice Address - Street 2:
Practice Address - City:HENDERSONVILLE
Practice Address - State:TN
Practice Address - Zip Code:37075-8619
Practice Address - Country:US
Practice Address - Phone:615-824-0978
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-14
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes246ZS0410XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, OtherSurgical Technologist