Provider Demographics
NPI:1104402767
Name:HAGER, SAMUEL ELHARDT (DO)
Entity type:Individual
Prefix:DR
First Name:SAMUEL
Middle Name:ELHARDT
Last Name:HAGER
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4686 N WILDFLOWERS WAY
Mailing Address - Street 2:
Mailing Address - City:CASTLE ROCK
Mailing Address - State:CO
Mailing Address - Zip Code:80109-8400
Mailing Address - Country:US
Mailing Address - Phone:701-202-6619
Mailing Address - Fax:
Practice Address - Street 1:8401 S CHAMBERS RD # A-11
Practice Address - Street 2:
Practice Address - City:ENGLEWOOD
Practice Address - State:CO
Practice Address - Zip Code:80112-3276
Practice Address - Country:US
Practice Address - Phone:720-874-2420
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-03-23
Last Update Date:2025-02-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CODR.0070052204D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes204D00000XAllopathic & Osteopathic PhysiciansNeuromusculoskeletal Medicine & OMM