Provider Demographics
NPI:1023484037
Name:HAGOPIAN, THOMAS (MD)
Entity type:Individual
Prefix:DR
First Name:THOMAS
Middle Name:
Last Name:HAGOPIAN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:99 KROG ST NE UNIT C110
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30307-2677
Mailing Address - Country:US
Mailing Address - Phone:404-885-8542
Mailing Address - Fax:404-885-8547
Practice Address - Street 1:99 KROG ST NE UNIT C110
Practice Address - Street 2:
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30307-2677
Practice Address - Country:US
Practice Address - Phone:404-885-8542
Practice Address - Fax:404-885-8547
Is Sole Proprietor?:No
Enumeration Date:2015-08-12
Last Update Date:2023-05-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA141069208200000X, 208200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208200000XAllopathic & Osteopathic PhysiciansPlastic Surgery