Provider Demographics
NPI:1073018065
Name:HAGGARD, MICHAEL HEATH (MD)
Entity Type:Individual
Prefix:DR
First Name:MICHAEL
Middle Name:HEATH
Last Name:HAGGARD
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:301 FISHER ST
Mailing Address - Street 2:
Mailing Address - City:BILOXI
Mailing Address - State:MS
Mailing Address - Zip Code:39534-2519
Mailing Address - Country:US
Mailing Address - Phone:228-376-0576
Mailing Address - Fax:228-376-0103
Practice Address - Street 1:301 FISHER ST
Practice Address - Street 2:
Practice Address - City:BILOXI
Practice Address - State:MS
Practice Address - Zip Code:39534-2519
Practice Address - Country:US
Practice Address - Phone:228-376-0576
Practice Address - Fax:228-376-0103
Is Sole Proprietor?:Yes
Enumeration Date:2018-03-29
Last Update Date:2022-07-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101268291207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine