Provider Demographics
NPI:1386617322
Name:HAGER, JAMES R (DO)
Entity type:Individual
Prefix:DR
First Name:JAMES
Middle Name:R
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:PO BOX 1433
Mailing Address - Street 2:
Mailing Address - City:PIKEVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:41502-1433
Mailing Address - Country:US
Mailing Address - Phone:606-218-6011
Mailing Address - Fax:606-218-6082
Practice Address - Street 1:255 CHURCH ST STE 102B
Practice Address - Street 2:
Practice Address - City:PIKEVILLE
Practice Address - State:KY
Practice Address - Zip Code:41501-3476
Practice Address - Country:US
Practice Address - Phone:606-218-6011
Practice Address - Fax:606-218-6082
Is Sole Proprietor?:No
Enumeration Date:2006-02-09
Last Update Date:2024-05-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY02889207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY1629114707OtherGROUP NPI EKAHC
KY000000502386OtherBCBS
KY64110547Medicaid
KY000000502386OtherBCBS
KY64110547Medicaid
KYI34880Medicare UPIN
KY0549019Medicare ID - Type Unspecified
183442Medicare ID - Type Unspecified
KY64110547Medicaid