Hagan, Dennis Keith

Hagan, Dennis Keith is an sole proprietor health care provider with primary practice located at 1240 E John Rowan Blvd , Bardstown KY 40004-2066. He recently has only one registered license in Suppliers / Customized Equipment, which is considered as his primary health care specialty. Hagan, Dennis Keith can be contacted via phone (502) 349-7119.

Contact Information

Primary practice address
1240 E John Rowan Blvd Bardstown KY 40004-2066
Fax:
Website:

Health care specialties

SpecialtyCodeLicense #State
Suppliers / Customized Equipment 332BC3200X

Profile Details

NPI number 1144277468
LBN Legal business name Hagan, Dennis Keith
Credentials COBBLER
Entity Individual
Sole proprietor 1 Yes
Enumeration date May 30th, 2006
Last updated Jan 20th, 2010 - about 16 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1144277468 NPPES
Kentucky MEDICAID 90011388
Kentucky Other 000000362306
Kentucky Other 50009643

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