Provider Demographics
NPI:1982762464
Name:THE HAGLUND CLINIC
Entity Type:Organization
Organization Name:THE HAGLUND CLINIC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:RODGER
Authorized Official - Middle Name:B
Authorized Official - Last Name:HAGLUND
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:325-695-8090
Mailing Address - Street 1:4627 S 14TH ST
Mailing Address - Street 2:
Mailing Address - City:ABILENE
Mailing Address - State:TX
Mailing Address - Zip Code:79605-4734
Mailing Address - Country:US
Mailing Address - Phone:325-695-8090
Mailing Address - Fax:325-695-4150
Practice Address - Street 1:4627 S 14TH ST
Practice Address - Street 2:
Practice Address - City:ABILENE
Practice Address - State:TX
Practice Address - Zip Code:79605-4734
Practice Address - Country:US
Practice Address - Phone:325-695-8090
Practice Address - Fax:325-695-4150
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-05
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXAH3222596207K00000X, 207KA0200X, 207KI0005X, 207N00000X, 207ND0900X, 207NI0002X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Not Answered207K00000XAllopathic & Osteopathic PhysiciansAllergy & ImmunologyGroup - Multi-Specialty
Not Answered207KA0200XAllopathic & Osteopathic PhysiciansAllergy & ImmunologyAllergyGroup - Multi-Specialty
Not Answered207KI0005XAllopathic & Osteopathic PhysiciansAllergy & ImmunologyClinical & Laboratory ImmunologyGroup - Multi-Specialty
Not Answered207N00000XAllopathic & Osteopathic PhysiciansDermatologyGroup - Multi-Specialty
Not Answered207ND0900XAllopathic & Osteopathic PhysiciansDermatologyDermatopathologyGroup - Multi-Specialty
Not Answered207NI0002XAllopathic & Osteopathic PhysiciansDermatologyClinical & Laboratory Dermatological ImmunologyGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXB23251Medicare UPIN
TX00L55LMedicare ID - Type Unspecified