Individual
DR. JESSE CORNELIUS HAGGERTY III
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD, MSC, MPH, PHD
Contact information
Practice address
515 STATE DOCKS RD, EUFAULA, AL 36027-3354
(334) 687-0250
(334) 687-0299
Mailing address
515 STATE DOCKS RD, EUFAULA, AL 36027-3354
(334) 687-0250
(334) 687-0299
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
049855
GA
207Q00000X
Family Medicine Physician
Primary
24003
AL
291U00000X
Clinical Medical Laboratory
01D0985382
AL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000910049A
—
GA
05
—
131642
—
AL
01
—
51125074
BC/BS
AL
Enumeration date
07/14/2005
Last updated
02/22/2019
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