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General NPI Number Information
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NPI Number | 1134154032
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Entity Type | Individual
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Provider Name | STEPHEN HAGGARD DPM PS
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Gender | Male
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Dates
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Enumeration Date | 07/11/2006
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Last Update Date | 10/22/2019
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Provider Practice Location Address
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Address Line | 210 27TH AVE APT F105
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City | MILTON
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State | WA
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Zip | 98354-8330
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Country | US
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Telephone | 253-334-5262
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Fax | 253-815-1651
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Provider Business Mailing Address
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Address Line | PO BOX 506
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City | MILTON
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State | WA
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Zip | 98354-0506
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Country | US
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Telephone | 253-661-5686
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Fax | 253-815-1651
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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 | 213ES0131X
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Taxonomy Name | Foot Surgery Podiatrist
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License Number | PO00000399
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License Number State | WA
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Taxonomy #2
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Taxonomy Code | 213EP1101X
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Taxonomy Name | Primary Podiatric Medicine Podiatrist
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License Number | PO00000399
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License Number State | WA
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