1609883479 NPI number — DR. CHRISTOPHER J HAGGERTY M.D.

Table of content: DR. CHRISTOPHER J HAGGERTY M.D. (NPI 1609883479)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1609883479 NPI number — DR. CHRISTOPHER J HAGGERTY M.D.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
HAGGERTY
Provider First Name:
CHRISTOPHER
Provider Middle Name:
J
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
M.D.
Provider Gender Code:
M

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1609883479
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
02/12/2023
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
341 COOL SPRINGS BLVD.
Provider Second Line Business Mailing Address:
STE. 400
Provider Business Mailing Address City Name:
FRANKLIN
Provider Business Mailing Address State Name:
TN
Provider Business Mailing Address Postal Code:
37067
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
423-508-7337
Provider Business Mailing Address Fax Number:
423-508-7338

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1400 DOWELL SPRINGS BLVD.
Provider Second Line Business Practice Location Address:
STE. 310
Provider Business Practice Location Address City Name:
KNOXVILLE
Provider Business Practice Location Address State Name:
TN
Provider Business Practice Location Address Postal Code:
37909-2445
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
865-966-7337
Provider Business Practice Location Address Fax Number:
865-966-7339
Provider Enumeration Date:
08/02/2006

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 207W00000X , with the licence number:  22323 , registered in the state of SC ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 207W00000X , with the licence number: 60639 , registered in the state of TN ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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