Hagedorn, David J
Hagedorn, David J is an individual health care provider with primary practice located at 2101 Kimball Avenue Suite 401, Waterloo IA 50702. He recently has only one registered license in Allopathic & Osteopathic Physicians / Family Medicine, which is considered as his primary health care specialty. Hagedorn, David J can be contacted via phone (319) 272-2002.Contact Information
Primary practice address
2101 Kimball Avenue Suite 401
Waterloo IA 50702
Phone: (319) 272-2002
Fax: (319) 272-2071
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Family Medicine | 207Q00000X | 03115 | Iowa |
Profile Details
| NPI number | 1922078369 |
|---|---|
| LBN Legal business name | Hagedorn, David J |
| Credentials | Doctor of Osteopathy (DO) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jan 26th, 2006 |
| Last updated | Jun 2nd, 2016 - about 8 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1922078369 | NPPES |
| Iowa | MEDICAID | 0725283 |
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