Provider Demographics
NPI:1376728352
Name:HAGG, JAMES (RPH)
Entity Type:Individual
Prefix:MR
First Name:JAMES
Middle Name:
Last Name:HAGG
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:503 SOUTH SECOND ST.
Mailing Address - Street 2:
Mailing Address - City:FULTON
Mailing Address - State:NY
Mailing Address - Zip Code:13069-4564
Mailing Address - Country:US
Mailing Address - Phone:315-593-2131
Mailing Address - Fax:315-592-9517
Practice Address - Street 1:503 SOUTH SECOND ST.
Practice Address - Street 2:
Practice Address - City:FULTON
Practice Address - State:NY
Practice Address - Zip Code:13069-4564
Practice Address - Country:US
Practice Address - Phone:315-593-2131
Practice Address - Fax:315-592-9517
Is Sole Proprietor?:No
Enumeration Date:2008-01-08
Last Update Date:2008-01-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY042435183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY00482839Medicaid