Provider Demographics
NPI:1972277952
Name:HAGGART MEDICAL CONSULTING, LLC
Entity Type:Organization
Organization Name:HAGGART MEDICAL CONSULTING, LLC
Other - Org Name:HAGGART MEDICAL CONSULTING LLC
Other - Org Type:Other Name
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MANDIE
Authorized Official - Middle Name:M
Authorized Official - Last Name:HAGGART
Authorized Official - Suffix:
Authorized Official - Credentials:NP-C
Authorized Official - Phone:318-308-3443
Mailing Address - Street 1:144 LOYD BRIDGE RD
Mailing Address - Street 2:
Mailing Address - City:CHENEYVILLE
Mailing Address - State:LA
Mailing Address - Zip Code:71325-9140
Mailing Address - Country:US
Mailing Address - Phone:318-308-3443
Mailing Address - Fax:
Practice Address - Street 1:2180 US HWY 71 S
Practice Address - Street 2:
Practice Address - City:LECOMPTE
Practice Address - State:LA
Practice Address - Zip Code:71346-7132
Practice Address - Country:US
Practice Address - Phone:318-290-3900
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-08-04
Last Update Date:2021-10-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Single Specialty