Provider Demographics
NPI:1780677757
Name:HAGEY, DEBORAH A (DO)
Entity Type:Individual
Prefix:
First Name:DEBORAH
Middle Name:A
Last Name:HAGEY
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:242A W MAIN ST
Mailing Address - Street 2:
Mailing Address - City:REINHOLDS
Mailing Address - State:PA
Mailing Address - Zip Code:17569-9516
Mailing Address - Country:US
Mailing Address - Phone:717-336-2326
Mailing Address - Fax:
Practice Address - Street 1:242A W MAIN ST
Practice Address - Street 2:
Practice Address - City:REINHOLDS
Practice Address - State:PA
Practice Address - Zip Code:17569-9516
Practice Address - Country:US
Practice Address - Phone:717-336-2326
Practice Address - Fax:
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-08-25
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOS006530L207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
PAHA603706Medicare ID - Type Unspecified
PAE65405Medicare UPIN