Provider Demographics
NPI:1477680197
Name:HAGANS, JAMES E III (MD)
Entity Type:Individual
Prefix:
First Name:JAMES
Middle Name:E
Last Name:HAGANS
Suffix:III
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9500 KANIS ROAD
Mailing Address - Street 2:SUITE 501
Mailing Address - City:LITTLE ROCK
Mailing Address - State:AR
Mailing Address - Zip Code:72205
Mailing Address - Country:US
Mailing Address - Phone:501-227-8166
Mailing Address - Fax:501-227-6482
Practice Address - Street 1:9500 KANIS ROAD
Practice Address - Street 2:SUITE 501
Practice Address - City:LITTLE ROCK
Practice Address - State:AR
Practice Address - Zip Code:72205
Practice Address - Country:US
Practice Address - Phone:501-227-8166
Practice Address - Fax:501-227-6482
Is Sole Proprietor?:No
Enumeration Date:2007-02-28
Last Update Date:2014-12-19
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
ARC6830208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
AR119419001Medicaid
C16429Medicare UPIN
AR119419001Medicaid
AR54531Medicare PIN