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General NPI Number Information
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NPI Number | 1053452151
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Entity Type | Individual
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Provider Name | COREY JAY HAGGARD M.D.
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Gender | Male
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Dates
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Enumeration Date | 02/09/2007
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Last Update Date | 11/12/2010
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Provider Practice Location Address
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Address Line | 4640 N LOOP 289
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City | LUBBOCK
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State | TX
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Zip | 79416-2423
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Country | US
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Telephone | 806-794-1223
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Fax | 806-589-0216
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Provider Business Mailing Address
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Address Line | PO BOX 98046
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City | LUBBOCK
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State | TX
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Zip | 79499-8046
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Country | US
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Telephone | 806-794-1223
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Fax | 806-589-0216
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207L00000X
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Taxonomy Name | Anesthesiology Physician
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License Number | H8102
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License Number State | TX
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Taxonomy #2
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Taxonomy Code | 207LP2900X
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Taxonomy Name | Pain Medicine (Anesthesiology) Physician
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License Number | H8102
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License Number State | TX
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