| Doctor Name: | BRANDY JO HAGUE |
| NPI Number: | 1295798734 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | PA-C |
| License Number: | MA052223 |
| Business Practice Address: | 100 Plaza Ct Suite C. Pocono Plastic And Reconstructive Surgery. E Stroudsburg, PA - 183018258 |
| Business Phone Number: | 5704206220 |
| Business Fax Number: | 5704206221 |
| Mailing Address: | 206 E Brown St, Pocono Healthcare Mgmt. - Professional Bldg. E STROUDSBURG |
| State: | PA |
| Postal Code: | 183013006 |
| Phone Number: | 5704204969 |
| Fax Number: | 5704763754 |
| NPI Enumeration Date: | 04/07/2006 |
| NPI Last Update Date: | 07/08/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363AS0400X |
| License Number: | MA052223 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | PA |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Physician Assistant |
| Taxonomy Specialization: | Surgical |
| Taxonomy Definition: | |