Basic Information
| Provider Information | |||||||||
| NPI: | 1659313708 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | HAGGARTY | ||||||||
| FirstName: | JOHN | ||||||||
| MiddleName: | BRUCE | ||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 248 PLEASANT ST | ||||||||
| Address2: | SUITE 2600 | ||||||||
| City: | CONCORD | ||||||||
| State: | NH | ||||||||
| PostalCode: | 033012588 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6032287400 | ||||||||
| FaxNumber: | 6032287403 | ||||||||
| Practice Location | |||||||||
| Address1: | 250 PLEASANT ST | ||||||||
| Address2: | |||||||||
| City: | CONCORD | ||||||||
| State: | NH | ||||||||
| PostalCode: | 033017539 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6032277140 | ||||||||
| FaxNumber: | 6032277187 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 06/12/2006 | ||||||||
| LastUpdateDate: | 02/10/2009 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207Q00000X | 9699 | NH | N | Allopathic & Osteopathic Physicians | Family Medicine | 207P00000X | 9699 | TX | Y | Allopathic & Osteopathic Physicians | Emergency Medicine |
No ID Information.