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Organization

FAMILY & COMMUNITY MEDICINE ASSOCIATES LLC

Active
Other names
Jess C Haggerty III Sole Mbr
Organization subpart
No

Provider details

NPI number
Authorized official
DR. JESSE CORNELIUS HAGGERTY III MD, PHD (PHYSICIAN)
(334) 687-0250
Entity
Organization

Contact information

Practice address
405 EAST BARBOUR STREET, SUITE 3, EUFAULA, AL 36027-1701
(334) 687-0250
(334) 687-0299
Mailing address
405 EAST BARBOUR STREET, SUITE 3, EUFAULA, AL 36027-1701
(334) 687-0250
(334) 687-0299

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
24003
AL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
009952520
AL
05
131642
AL
01
51117736
BCBS PROVIDER #
AL
01
51501961
BCBS PROVIDER #
AL
01
51536749
BCBS PROVIDER #
AL
01
63-1271382
TRICARE PROVIDER #
AL
Enumeration date
10/06/2006
Last updated
06/20/2018
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