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DR. JESSE CORNELIUS HAGGERTY MD, MSC, MPH, PHD

>> Family Medicine >> Allopathic & Osteopathic Physicians

Registrant NPI Number: 1447258215

Individual Registrant:
DR. JESSE CORNELIUS HAGGERTY MD, MSC, MPH, PHD
Gender: M
Sole Proprietor

Location and contact information for practice:
515 STATE DOCKS RD  EUFAULA, AL 36027-3354 US
Tel: 334-687-0250  Fax: 334-687-0299

Contact information for business:
515 STATE DOCKS RD  EUFAULA, AL 36027-3354 US
Tel: 334-687-0250  Fax: 334-687-0299

Registration Information:
NPI: 1447258215
Entity Type: Individual

Specialty information:

PrimaryCodeCategory/DescriptionStateLicense Number
N207Q00000XAllopathic & Osteopathic Physicians
Family Medicine
GA049855
N291U00000XLaboratories
Clinical Medical Laboratory
AL01D0985382
Y207Q00000XAllopathic & Osteopathic Physicians
Family Medicine
AL24003

Legacy codes, insurance codes and state license numbers:

IssuerNumberStateType
000910049AGA05
131642AL05
BC/BS51125074AL01




HEALTH CARE JOBS AL - Page 1



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