Provider Demographics
NPI:1316915358
Name:HAZARD, ROGER A (PHYSICIAN ASSISTANT)
Entity type:Individual
Prefix:MR
First Name:ROGER
Middle Name:A
Last Name:HAZARD
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Gender:M
Credentials:PHYSICIAN ASSISTANT
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Mailing Address - Street 1:1300 HOSPITAL DR STE 220
Mailing Address - Street 2:
Mailing Address - City:MT PLEASANT
Mailing Address - State:SC
Mailing Address - Zip Code:29464-3208
Mailing Address - Country:US
Mailing Address - Phone:843-936-6238
Mailing Address - Fax:843-936-6239
Practice Address - Street 1:1300 HOSPITAL DR STE 220
Practice Address - Street 2:
Practice Address - City:MT PLEASANT
Practice Address - State:SC
Practice Address - Zip Code:29464-3208
Practice Address - Country:US
Practice Address - Phone:843-936-6238
Practice Address - Fax:843-936-6239
Is Sole Proprietor?:No
Enumeration Date:2006-03-08
Last Update Date:2024-06-21
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant