Provider Demographics
NPI:1609892066
Name:HAGAN, PAUL JR (MD)
Entity Type:Individual
Prefix:
First Name:PAUL
Middle Name:
Last Name:HAGAN
Suffix:JR
Gender:M
Credentials:MD
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Mailing Address - Street 1:120 CHARLES D ROLLINS RD
Mailing Address - Street 2:SUITE 201
Mailing Address - City:HENDERSON
Mailing Address - State:NC
Mailing Address - Zip Code:27536-2882
Mailing Address - Country:US
Mailing Address - Phone:252-430-8111
Mailing Address - Fax:252-430-1804
Practice Address - Street 1:120 CHARLES D ROLLINS RD
Practice Address - Street 2:SUITE 201
Practice Address - City:HENDERSON
Practice Address - State:NC
Practice Address - Zip Code:27536-2882
Practice Address - Country:US
Practice Address - Phone:252-430-8111
Practice Address - Fax:252-430-1804
Is Sole Proprietor?:No
Enumeration Date:2006-07-15
Last Update Date:2007-07-08
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
NC35907207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NCE23686Medicare UPIN