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1235524653
KENTON LEE HAGAN
FAYETTEVILLE, AR
NPI
1235524653
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
207X00000X Orthopaedic Surgery
(Licence: AR E-12883)
Enumeration Date
2015-04-02
Last Update Date
2020-09-15
Business Address
KENTON LEE HAGAN
3900 N PARKVIEW DR
FAYETTEVILLE, AR 72703-6398
Phone number: 479-966-4187
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Mailing Address
KENTON LEE HAGAN
3900 N PARKVIEW DR
FAYETTEVILLE, AR 72703-6398
Phone number: 479-966-4187
Copy
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