Warren Eugene Hagan, M.D.

Primary specialty

Otolaryngology PhysicianTaxonomy code 207Y00000X

License

036141011 Issued in IL

Practice address

1132 Broadway St
Suite 200
Quincy, IL 62301-2819

Phone

(217) 224-6423

NPI assigned

Jun 23, 2006

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 4

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Midwest Heart and Vein Center, LLC

  • Cardiovascular Disease Physician
  • Moberly, MO
  • NPI 1760855738
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1151020800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1473206400000",
    "number": "1164458105",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1132 BROADWAY ST",
            "address_2": "SUITE 200",
            "city": "QUINCY",
            "state": "IL",
            "postal_code": "623012819",
            "telephone_number": "217-224-6423"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1132 BROADWAY ST",
            "address_2": "SUITE 200",
            "city": "QUINCY",
            "state": "IL",
            "postal_code": "623012819",
            "telephone_number": "217-224-6423"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HAGAN",
        "first_name": "WARREN",
        "middle_name": "EUGENE",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-23",
        "last_updated": "2016-09-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208200000X",
            "taxonomy_group": "",
            "desc": "Plastic Surgery",
            "state": "MO",
            "license": "R6867",
            "primary": false
        },
        {
            "code": "207Y00000X",
            "taxonomy_group": "",
            "desc": "Otolaryngology",
            "state": "MO",
            "license": "R6867",
            "primary": false
        },
        {
            "code": "208200000X",
            "taxonomy_group": "",
            "desc": "Plastic Surgery",
            "state": "IL",
            "license": "036141011",
            "primary": false
        },
        {
            "code": "207Y00000X",
            "taxonomy_group": "",
            "desc": "Otolaryngology",
            "state": "IL",
            "license": "036141011",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1164458105",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Brianne Blythe Guymon, MS, ATC
• Robert Haag, MD
• Robert J Haas, LCSW
• Mike Horst Hackmann, M.D.
• Susan E. Haerr, MA, LCPC, LPHA
• Linda S. Hageman, NP
• Sarah Lucille Hageman, LCSW
• Verda Haiducek, LCPC
• Heidi M Haisley, OD
• Austin Hake, M.D.

• All providers in Quincy, IL
• Otolaryngology Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 7, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.