Hagen, Jedd A
Hagen, Jedd A is an sole proprietor health care provider with primary practice located at 311 S Clark St , Carroll IA 51401-3038. He recently has only one registered license in Allopathic & Osteopathic Physicians / Medical Microbiology, which is considered as his primary health care specialty. Hagen, Jedd A can be contacted via phone (712) 792-8257.Contact Information
Primary practice address
311 S Clark St
Carroll IA 51401-3038
Phone: (712) 792-8257
Fax: (712) 792-8234
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Medical Microbiology | 207ZM0300X | 30259 | Iowa |
Profile Details
| NPI number | 1831206234 |
|---|---|
| LBN Legal business name | Hagen, Jedd A |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Aug 23rd, 2006 |
| Last updated | Sep 10th, 2021 - 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1831206234 | NPPES |
| Iowa | MEDICAID | 0119636 | |
| Iowa | Other | 50190 |
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