Individual ProviderShelton HagerFamily MedicineAllopathic & Osteopathic PhysiciansPractice Address105 W Stone Dr, Ste 3a, Kingsport, TN 37660-3256(423) 392-6200(423) 857-2066PECOS EnrollmentBased on the most recent information from CMS, provider Shelton Hager is legally eligible to order and refer claims for Part B, HHA, DME and PMD services.Part BMedicare Part BEnrolledHHAHome Health AgencyEnrolledDMEDurable Medical EquipmentEnrolledPMDPower Mobility DeviceEnrolledCMS last updated its PECOS records yesterday at 4:18 PM.Profile DetailsProvider ID1407859796Provider TypeIndividualFull NameHager, SheltonTitleDr.CredentialM.D.GenderMaleSole ProprietorNoEnumeration Date5/31/2005Last Updated9/16/2019Contact InformationPractice LocationPractice Address105 W Stone Dr, Ste 3a, Kingsport, TN 37660-3256Phone(423) 392-6200Fax(423) 392-6593Mailing LocationMailing AddressPO Box 9, Kingsport, TN 37662-0009Phone(423) 857-2066Fax(423) 857-2070Provider TaxonomiesCodeDescriptionLicenseCode207Q00000XPrimaryDescriptionFamily MedicineAllopathic & Osteopathic PhysiciansLicense39196TennesseeProvider IdentifiersIDDescriptionIssuerID10134706DescriptionMedicaidIssuerUnlistedVirginiaID3325584DescriptionMedicaidIssuerUnlistedTennessee