Individual
REGG A HAGGE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
711 ONYX ST, KEMMERER, WY 83101-3214
(307) 877-4496
(307) 877-9769
Mailing address
711 ONYX ST, KEMMERER, WY 83101-3214
(307) 877-4496
(307) 877-9769
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
11278A
WY
207Q00000X
Family Medicine Physician
Primary
5642
SD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
5607445
—
SD
05
—
5607446
—
SD
Enumeration date
05/19/2006
Last updated
05/17/2021
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