Provider Demographics
NPI:1730125485
Name:HAGAN, DONALD J (MD)
Entity Type:Individual
Prefix:DR
First Name:DONALD
Middle Name:J
Last Name:HAGAN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8205 NW HIGHWAY 225
Mailing Address - Street 2:
Mailing Address - City:OCALA
Mailing Address - State:FL
Mailing Address - Zip Code:34482-1859
Mailing Address - Country:US
Mailing Address - Phone:352-351-2280
Mailing Address - Fax:352-351-3909
Practice Address - Street 1:8205 NW HIGHWAY 225
Practice Address - Street 2:
Practice Address - City:OCALA
Practice Address - State:FL
Practice Address - Zip Code:34482-1859
Practice Address - Country:US
Practice Address - Phone:352-351-2280
Practice Address - Fax:352-351-3909
Is Sole Proprietor?:No
Enumeration Date:2006-06-21
Last Update Date:2010-08-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME0010480208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL060134900Medicaid
FL13491Medicare ID - Type Unspecified
FL060134900Medicaid