Individual
HAGGAN JULIJANTO
Active
Sole proprietor
No
Provider details
NPI number
Gender
X
Contact information
Practice address
2004 W SYCAMORE ST, KOKOMO, IN 46901-4112
(574) 780-0102
Mailing address
14053 FOUR SEASONS WAY, CARMEL, IN 46074-8588
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
10005054A
IN
Other
Enumeration date
10/21/2025
Last updated
10/21/2025
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