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NPI Code Detail

MEDICARE: MR. ELDON EUGENE HAGGARD PA

MEDICARE: MR. ELDON EUGENE HAGGARD PA
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
1363A00000XPhysician Assistant

General Provider Information

NPI Number : 1013014125
Entity Type Code : Individual
Provider Name (Legal Business Name) : MR. ELDON EUGENE HAGGARD PA
Provider Business Mailing Address
First Line : 9322 E 41ST ST
Second Line :
City : TULSA
State : OK
Zip : 74145-3721
Country : US
Telephone Number : 918-764-7234
Fax Number :
Provider Business Practice Location Address
First Line : 9322 E 41ST ST
Second Line :
City : TULSA
State : OK
Zip : 74145-3721
Country : US
Telephone Number : 918-764-7234
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/20/2006
Last Update Date : 04/12/2026

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Directions to “ MR. ELDON EUGENE HAGGARD PA” Practice Location

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