Hagan, Kyle

Hagan, Kyle is an individual health care provider with primary practice located at 1400 S Germantown Rd , Germantown TN 38138-2205. He recently has 2 registered licenses in different health care specialties including Other Service Providers / Military Health Care Provider, Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant. Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant is his primary health care specialty. Hagan, Kyle can be contacted via phone (901) 759-3100.

Contact Information

Primary practice address
1400 S Germantown Rd Germantown TN 38138-2205
Phone: (901) 759-3100
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Other Service Providers / Military Health Care Provider 171000000X
Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant 363A00000X

Profile Details

NPI number 1841719390
LBN Legal business name Hagan, Kyle
Credentials PA0C
Entity Individual
Sole proprietor 1 No
Enumeration date Sep 15th, 2017
Last updated Oct 5th, 2022 - about 3 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1841719390 NPPES
Mississippi MEDICAID 08402771
Mississippi MEDICAID Q061378

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