Ian Storm Haggard, D.M.D.

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

D-0006969-C1 Issued in AL

Practice address

721 W Market St Ste a
Athens, AL 35611-2456

Phone

(256) 232-3415

Fax

(256) 230-2648

NPI assigned

Sep 2, 2021

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1630540800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1630540800000",
    "number": "1891463063",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "721 W MARKET ST STE A",
            "city": "ATHENS",
            "state": "AL",
            "postal_code": "356112456",
            "telephone_number": "256-232-3415"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "721 W MARKET ST STE A",
            "city": "ATHENS",
            "state": "AL",
            "postal_code": "356112456",
            "telephone_number": "256-232-3415",
            "fax_number": "256-230-2648"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HAGGARD",
        "first_name": "IAN",
        "middle_name": "STORM",
        "name_prefix": "Dr.",
        "credential": "D.M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-09-02",
        "last_updated": "2021-09-02",
        "certification_date": "2021-09-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "AL",
            "license": "D-0006969-C1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Hall Chiropractic Clinic, Inc.
• Charles Ronald Hall, R.PH., D.C.
• Elizabeth Anne Hall, CCC-SLP

• General Practice Dentistry in Athens, AL
• Providers in Athens, AL by specialty
• General Practice Dentistry in Alabama

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 2, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.