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NPI Code Detail

MEDICARE: ADAM J HAGGERTY D.O.

MEDICARE: ADAM J HAGGERTY D.O.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1208VP0014XInterventional Pain Medicine Physician70302-21WI
2207P00000XEmergency Medicine Physician70302WI

General Provider Information

NPI Number : 1043741507
Entity Type Code : Individual
Provider Name (Legal Business Name) : ADAM J HAGGERTY D.O.
Provider Business Mailing Address
First Line : 1035 KEPLER DR
Second Line :
City : GREEN BAY
State : WI
Zip : 54311-8320
Country : US
Telephone Number : 920-490-9046
Fax Number : 920-405-8005
Provider Business Practice Location Address
First Line : 2845 GREENBRIER RD
Second Line :
City : GREEN BAY
State : WI
Zip : 54311-6519
Country : US
Telephone Number : 920-288-8377
Fax Number : 920-288-8385
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/25/2017
Last Update Date : 06/02/2026

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