Provider Demographics
NPI:1467748715
Name:HAGGARD, REBEKAH MARIE (MD)
Entity Type:Individual
Prefix:DR
First Name:REBEKAH
Middle Name:MARIE
Last Name:HAGGARD
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:105 WESTPARK DR
Mailing Address - Street 2:SUITE 200
Mailing Address - City:BRENTWOOD
Mailing Address - State:TN
Mailing Address - Zip Code:37027-5319
Mailing Address - Country:US
Mailing Address - Phone:615-376-1317
Mailing Address - Fax:615-309-9421
Practice Address - Street 1:105 WESTPARK DR
Practice Address - Street 2:SUITE 200
Practice Address - City:BRENTWOOD
Practice Address - State:TN
Practice Address - Zip Code:37027-5319
Practice Address - Country:US
Practice Address - Phone:615-376-1317
Practice Address - Fax:615-309-9421
Is Sole Proprietor?:No
Enumeration Date:2011-06-24
Last Update Date:2011-06-24
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TN45331207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
G63837Medicare UPIN