Hagen, George H

Hagen, George H is an sole proprietor health care provider with primary practice located at 1114 E Main St , Trinidad CO 81082-2034. He recently has 3 registered licenses in different health care specialties including Eye and Vision Services Providers / Optometrist, Suppliers / Durable Medical Equipment & Medical Supplies, Suppliers / Eyewear Supplier (Equipment, not the service). Eye and Vision Services Providers / Optometrist is his primary health care specialty. Hagen, George H can be contacted via phone (719) 846-7342.

Contact Information

Primary practice address
1114 E Main St Trinidad CO 81082-2034
Phone: (719) 846-7342
Fax: (719) 846-4041
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Eye and Vision Services Providers / Optometrist 152W00000X 835 Colorado
Suppliers / Durable Medical Equipment & Medical Supplies 332B00000X
Suppliers / Eyewear Supplier (Equipment, not the service) 332H00000X

Profile Details

NPI number 1114019056
LBN Legal business name Hagen, George H
Credentials Doctor of Optometry (OD)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Sep 29th, 2006
Last updated May 8th, 2008 - about 18 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.

Request for update

Identifiers

StateTypeNumberIssuer
All States NPI 1114019056 NPPES
Colorado MEDICAID 08008351

Popular Providers