Provider Demographics
NPI:1679676431
Name:HAGGARD, JAROD ROY (DC)
Entity Type:Individual
Prefix:DR
First Name:JAROD
Middle Name:ROY
Last Name:HAGGARD
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 417
Mailing Address - Street 2:
Mailing Address - City:BELTON
Mailing Address - State:SC
Mailing Address - Zip Code:29627-0417
Mailing Address - Country:US
Mailing Address - Phone:864-338-4744
Mailing Address - Fax:864-338-4745
Practice Address - Street 1:1404 ANDERSON ST
Practice Address - Street 2:
Practice Address - City:BELTON
Practice Address - State:SC
Practice Address - Zip Code:29627-2414
Practice Address - Country:US
Practice Address - Phone:864-338-4744
Practice Address - Fax:864-338-4745
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-07
Last Update Date:2007-10-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC2791111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
SCCH2791Medicaid
SCAA01120281Medicare UPIN