Provider Demographics
NPI:1437200037
Name:HAGLER, CANDICE TERRY (MD)
Entity Type:Individual
Prefix:DR
First Name:CANDICE
Middle Name:TERRY
Last Name:HAGLER
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:CANDICE
Other - Middle Name:MECHELLE
Other - Last Name:TERRY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:1450 JONES DAIRY ROAD
Mailing Address - Street 2:BLDG 600
Mailing Address - City:JASPER
Mailing Address - State:AL
Mailing Address - Zip Code:35501-6109
Mailing Address - Country:US
Mailing Address - Phone:205-387-8159
Mailing Address - Fax:205-387-8262
Practice Address - Street 1:1450 JONES DAIRY ROAD
Practice Address - Street 2:BLDG 900
Practice Address - City:JASPER
Practice Address - State:AL
Practice Address - Zip Code:35501-6108
Practice Address - Country:US
Practice Address - Phone:205-387-8159
Practice Address - Fax:205-387-8262
Is Sole Proprietor?:No
Enumeration Date:2007-01-12
Last Update Date:2012-08-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL27732207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine