Provider Demographics
NPI:1477181154
Name:SMITH, HAGEN ELIZABETH (MD)
Entity type:Individual
Prefix:
First Name:HAGEN
Middle Name:ELIZABETH
Last Name:SMITH
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8040 PRINCETON GLENDALE RD
Mailing Address - Street 2:
Mailing Address - City:WEST CHESTER
Mailing Address - State:OH
Mailing Address - Zip Code:45069-5802
Mailing Address - Country:US
Mailing Address - Phone:513-246-7008
Mailing Address - Fax:513-246-5488
Practice Address - Street 1:8040 PRINCETON GLENDALE RD
Practice Address - Street 2:
Practice Address - City:WEST CHESTER
Practice Address - State:OH
Practice Address - Zip Code:45069-5802
Practice Address - Country:US
Practice Address - Phone:513-246-7008
Practice Address - Fax:513-246-5488
Is Sole Proprietor?:No
Enumeration Date:2020-03-30
Last Update Date:2024-09-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
OH35.150980207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program