Haggerty, Jesse Cornelius
Haggerty, Jesse Cornelius is an sole proprietor health care provider with primary practice located at 515 State Docks Rd , Eufaula AL 36027-3354. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Family Medicine, Laboratories / Clinical Medical Laboratory. Allopathic & Osteopathic Physicians / Family Medicine is his primary health care specialty. Haggerty, Jesse Cornelius can be contacted via phone (334) 687-0250.Contact Information
Primary practice address
515 State Docks Rd
Eufaula AL 36027-3354
Phone: (334) 687-0250
Fax: (334) 687-0299
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Family Medicine | 207Q00000X | 049855 | Georgia |
| Laboratories / Clinical Medical Laboratory | 291U00000X | 01D0985382 | Alabama |
| Allopathic & Osteopathic Physicians / Family Medicine | 207Q00000X | 24003 | Alabama |
Profile Details
| NPI number | 1447258215 |
|---|---|
| LBN Legal business name | Haggerty, Jesse Cornelius |
| Credentials | MD, MSC, MPH, PHD |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Jul 14th, 2005 |
| Last updated | Feb 22nd, 2019 - about 5 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 | 1447258215 | NPPES |
| Alabama | MEDICAID | 131642 | |
| Alabama | Other | 51125074 | |
| Alabama | MEDICAID | 000910049A |
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