Provider Demographics
NPI:1518355148
Name:HAGER, PAMELA KAY
Entity Type:Individual
Prefix:
First Name:PAMELA
Middle Name:KAY
Last Name:HAGER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2720 WESTROCK DR
Mailing Address - Street 2:
Mailing Address - City:HILLIARD
Mailing Address - State:OH
Mailing Address - Zip Code:43026-8148
Mailing Address - Country:US
Mailing Address - Phone:614-876-1411
Mailing Address - Fax:
Practice Address - Street 1:2680 GOLDENSTRAND DR
Practice Address - Street 2:
Practice Address - City:HILLIARD
Practice Address - State:OH
Practice Address - Zip Code:43026-8076
Practice Address - Country:US
Practice Address - Phone:614-850-7461
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-01-05
Last Update Date:2015-01-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171W00000XOther Service ProvidersContractor