Provider Demographics
NPI:1801020706
Name:HAGEWOOD, JOE DALLAS (REP T)
Entity Type:Individual
Prefix:
First Name:JOE
Middle Name:DALLAS
Last Name:HAGEWOOD
Suffix:
Gender:M
Credentials:REP T
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:777 E GIRARD AVE STE 250
Mailing Address - Street 2:
Mailing Address - City:ENGLEWOOD
Mailing Address - State:CO
Mailing Address - Zip Code:80113-2784
Mailing Address - Country:US
Mailing Address - Phone:720-214-2549
Mailing Address - Fax:303-744-7876
Practice Address - Street 1:4321 CAROTHERS PKWY
Practice Address - Street 2:
Practice Address - City:FRANKLIN
Practice Address - State:TN
Practice Address - Zip Code:37067-5909
Practice Address - Country:US
Practice Address - Phone:615-435-5000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-05-06
Last Update Date:2009-05-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes246ZE0600XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, OtherElectroneurodiagnostic