Individual
KYLE HAGGERTY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
2821 DAGGETT AVE STE 100, KLAMATH FALLS, OR 97601-1130
(541) 274-6733
Mailing address
2821 DAGGETT AVE STE 100, KLAMATH FALLS, OR 97601-1130
(541) 274-6733
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
PG210775
OR
390200000X
Student in an Organized Health Care Education/Training Program
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Other
Enumeration date
01/17/2020
Last updated
05/17/2022
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