| Hagerman Family Physicians, Inc | |
|
128 Depot St Wauseon OH 43567-1305 | |
| (419) 335-0351 | |
| (419) 335-0397 |
| Full Name | Hagerman Family Physicians, Inc |
|---|---|
| Speciality | Clinic/Center |
| Location | 128 Depot St, Wauseon, Ohio |
| Authorized Official Name and Position | Kimberly L Hagerman (OWNER) |
| Authorized Official Contact | 4193350351 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Hagerman Family Physicians, Inc 128 Depot St Wauseon OH 43567-1305 Ph: (419) 335-0351 | Hagerman Family Physicians, Inc 128 Depot St Wauseon OH 43567-1305 Ph: (419) 335-0351 |
| NPI Number | 1538266739 |
|---|---|
| Provider Enumeration Date | 09/20/2006 |
| Last Update Date | 12/16/2009 |
| Medicare PECOS PAC ID | 6204824576 |
|---|---|
| Medicare Enrollment ID | O20091214000776 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1538266739 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QP2300X | Clinic/center - Primary Care | 35076863 (Ohio) | Primary |
| 261QP2300X | Clinic/center - Primary Care | 35082560 (Ohio) | Secondary |
| Provider Name | Kimberly Loann Hagerman |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1487650446 PECOS PAC ID: 8022006394 Enrollment ID: I20090202000131 |
| Provider Name | Melissa A Pifer |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1396150009 PECOS PAC ID: 9133345515 Enrollment ID: I20170807001928 |
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