Provider Demographics
NPI:1720123359
Name:BRIAN P HAGGERTY DC INC
Entity type:Organization
Organization Name:BRIAN P HAGGERTY DC INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:BRIAN
Authorized Official - Middle Name:PATRICK
Authorized Official - Last Name:HAGGERTY
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:954-570-7699
Mailing Address - Street 1:PO BOX 8587
Mailing Address - Street 2:
Mailing Address - City:DEERFIELD BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33443-8587
Mailing Address - Country:US
Mailing Address - Phone:954-570-7699
Mailing Address - Fax:954-570-7698
Practice Address - Street 1:910 NE 2ND ST
Practice Address - Street 2:
Practice Address - City:DEERFIELD BEACH
Practice Address - State:FL
Practice Address - Zip Code:33441-2138
Practice Address - Country:US
Practice Address - Phone:954-570-7699
Practice Address - Fax:954-570-7698
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-21
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCH7618111NI0900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111NI0900XChiropractic ProvidersChiropractorInternistGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL3224470OtherDR HAGGERTY CIGNA #
FL2100148OtherDR HAGGERTYFIRST HEALTH #
FL40974OtherBCBS GROUP #
FL647625OtherDR HAGGERTY UHC #
FL1811034754OtherBRIAN HAGGERTY, DC NPI #
FLE14554Medicare UPIN
FL1811034754OtherBRIAN HAGGERTY, DC NPI #
FL93982ZMedicare ID - Type UnspecifiedDR DOBEN MEDICARE #
FL55805Medicare ID - Type UnspecifiedDR. HAGGERTY MEDICARE #