| NPI | 1649538794 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JESSE CORNELIUS HAGGERTY Physician 334-687-0250 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: AL 24003) |
| Enumeration Date | 2012-04-26 |
| Last Update Date | 2015-05-28 |