DR. JOHN GERALD HAGAN IV (NPI# 1548790165) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1548790165 |
| Entity Type | Individual |
| Full Name | DR. JOHN GERALD HAGAN IV |
| Credential | DO |
| Practice Address |
16001 W. Nine Mile Road Southfield MI 48075 |
| Mailing Address |
16001 W 9 Mile Rd Southfield MI 48075-4818 |
| Practice Telephone | (248) 849-3000 |
| Practice Fax Number | 2488495324 |
| Mailing Telephone | 2488493000 |
| Mailing Fax Number | 2488495324 |
| Enumeration Date | 2017-06-15 |
| Last Update Date | 2020-04-02 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207Q00000X | Family Medicine | 5101025515 | MI | Allopathic & Osteopathic Physicians |
| N | 390200000X | Student in an Organized Health Care Education/Training Program | MI | Student, Health Care |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1508371220 | John Hagan | Pharmacist | 380 S Fairview Ave, Elmhurst, IL 60126-3711 | 2017-12-04 |
| 1851480354 | John Hagan | Nurse Anesthetist, Certified Registered | 1501 E Mockingbird Ln Ste 220, Victoria, TX 77904-2194 | 2006-10-12 |
| 1295167997 | John Hagan | Physical Therapist | 740 Marne Hwy, Ste 203, Moorestown, NJ 08057-3127 | 2013-08-05 |
| 1740489970 | John Hagan | Nurse Practitioner | 827 Linden Ave, Baltimore, MD 21201-4606 | 2007-07-17 |
| 1598819856 | John J Hagan | Internal Medicine | 900 E Broadway Avenue, Bismarck, ND 58501 | 2007-01-23 |
| 1194749093 | John Stephens Hagan | Pharmacist | 511 Memorial Blvd, Springfield, TN 37172-2905 | 2006-07-26 |
| 1366429573 | John B Hagan | Allergy & Immunology | 200 1st St Sw, Rochester, MN 55905-0001 | 2005-12-29 |
| 1922091297 | John Charles Hagan IIi | Ophthalmology | 9401 N Oak Trfy, Ste 200, Kansas City, MO 64155-2233 | 2005-08-23 |
| Street Address |
16001 W. NINE MILE ROAD |
| City | SOUTHFIELD |
| State | MI |
| Zip Code | 48075 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1053769299 | Reham Haroun | Student in an Organized Health Care Education/Training Program | 16001 W. Nine Mile Road, Providence-providence Park Hospitals - Southfield, Southfield, MI 48075 | 2016-05-27 |
| 1619468782 | Abhiroop Verma | Student in an Organized Health Care Education/Training Program | 16001 W. Nine Mile Road, Southfield, MI 48075 | 2018-05-24 |
| 1295265890 | Nadine N Dawood | Physician Assistant | 16001 W. Nine Mile Road, Southfield, MI 48075-4807 | 2017-06-15 |
| 1568810208 | Eric William Hart | Student in an Organized Health Care Education/Training Program | 16001 W. Nine Mile Road, Providence-providence Park Hospitals-southfield, Southfield, MI 48075 | 2016-06-02 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1851900054 | K&b Medical Wigs, LLC | Durable Medical Equipment & Medical Supplies | 16250 Northland Dr. Ste 221, Southfield, MI 48075 | 2020-07-24 |
| 1790300390 | Julian Jeberaeel | Radiology | 2250 Providence, Southfield, MI 48075 | 2020-06-10 |
| 1265056410 | Husein Yusuf Husein | Podiatrist | Ascension Providence Hospital Southfield Campus, 16001 W. Nine Mile Rd. Depaul 2nd Floor, Southfield, Mi, MI 48075 | 2020-06-03 |
| 1952945420 | Paris Straughter | Nurse Practitioner | 18438 Onyx St, Southfield, MI 48075 | 2019-10-29 |
| 1811467657 | Medicine Man Medical, Pllc | Physical Medicine & Rehabilitation | 25130 Southfield Road, Suite #210, Southfield, MI 48075 | 2018-12-04 |
| 1447725528 | Rommel Ramos Perez | Physical Therapist | 26017 Greenfield Rd., Southfield, MI 48075 | 2018-10-04 |
| 1073009627 | Jacqueline Venora Goodgame | Licensed Practical Nurse | 4000 Town Ctr, Southfield, MI 48075 | 2018-07-06 |
| 1043712532 | Hollie Marie Maltese | Physical Therapy Assistant | 22255 Greenfiled 118, Southfield, MI 48075 | 2018-03-01 |
| 1932601481 | Katie Marie Mccormack | Occupational Therapist | 16001 West Nine Mile Rd., Southfield, MI 48075 | 2018-03-01 |
| 1801304241 | Absolute Hc LLC | Physical Therapist | 23461 Greenfield Rd Ste 200b, Southfield, MI 48075 | 2018-01-19 |
| Find all providers in zip 48075 | ||||
| Taxonomy Code | 207Q00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Family Medicine |
| Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. |
| Notes: Source: American Board of Family Medicine [1/1/2007: changed title; 7/1/2007: added definition, added source; 7/1/2017: modified definition] - Note: The American Osteopathic Board of Family Physicians certification includes extensive use of Osteopathic Manipulative Treatment (OMT), which integrates the biological, clinical, and behavioral sciences. - Additional Resources: American Board of Family Medicine, www.theabfm.org. American Osteopathic Board of Family Physicians, www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Family Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Family Physicians or the American Board of Family Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1699398081 | Natalie Bacheldor | Family Medicine | 22250 Providence Drive Suite 557, Southfield, MI 48075-4818 | 2020-05-20 |
| 1346806734 | Michigan Visiting Physician Services, Inc | Family Medicine | 21751 W 11 Mile Rd Ste 204, Southfield, MI 48076-3779 | 2019-05-12 |
| 1174031942 | Providence Homecare Providers Pllc | Family Medicine | 25511 Southfield Rd Ste 118, Southfield, MI 48075-1830 | 2018-01-16 |
| 1225567944 | Bilal Tarek Malek | Family Medicine | 23648 Lahser Rd, Southfield, MI 48033-3250 | 2017-06-06 |
| 1457894461 | Residential Physicians Association, Pllc | Family Medicine | 28300 Franklin Rd Ste 100, Southfield, MI 48034-1657 | 2016-11-22 |
| 1194104885 | Lorenzo Ray Mata Lim | Family Medicine | 23077 Greenfield Rd Ste 195, Southfield, MI 48075-3750 | 2015-05-27 |
| 1194147959 | Premier Family Medicine Pllc | Family Medicine | 23031 Wrexford Dr, Southfield, MI 48033-6575 | 2014-01-14 |
| 1306195730 | Southfield Family Practice Pllc | Family Medicine | 22972 Lahser Road, Southfield, MI 48033 | 2012-08-30 |
| 1760745434 | Latoya Tamara Austin | Family Medicine | 22250 Providence Dr Ste 557, Southfield, MI 48075-4825 | 2012-06-19 |
| 1508124082 | Thomas Mays Md, PC | Family Medicine | 20905 Greenfield Rd Ste 201, Southfield, MI 48075-5346 | 2012-05-02 |
| Find all providers in SOUTHFIELD | ||||
| City | SOUTHFIELD |
| Zip Code | 48075 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.