Haggard, Joe Rex
Haggard, Joe Rex is an individual health care provider with primary practice located at 1055 N 300 W Ste 204, Provo UT 84604-3374. He recently has only one registered license in Eye and Vision Services Providers / Optometrist, which is considered as his primary health care specialty. Haggard, Joe Rex can be contacted via phone (801) 357-7373.Contact Information
Primary practice address
1055 N 300 W Ste 204
Provo UT 84604-3374
Phone: (801) 357-7373
Fax: (801) 357-7217
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Eye and Vision Services Providers / Optometrist | 152W00000X | 1131489934 | Utah |
Profile Details
| NPI number | 1508863978 |
|---|---|
| LBN Legal business name | Haggard, Joe Rex |
| Credentials | Doctor of Optometry (OD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jun 30th, 2005 |
| Last updated | Jun 8th, 2021 - about 3 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1508863978 | NPPES |
| Utah | MEDICAID | D0696 |
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