| Doctor Name: | DR. CLEMENS E. HAGGERTY |
| NPI Number: | 1952300923 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | D.O. |
| License Number: | 30307 |
| Business Practice Address: | 2333 Highway 17 Iberia, MO - 654869331 |
| Business Phone Number: | 5737936900 |
| Business Fax Number: | 5737936688 |
| Mailing Address: | Po Box 1500, OSAGE BEACH |
| State: | MO |
| Postal Code: | 650651500 |
| Phone Number: | |
| Fax Number: | |
| NPI Enumeration Date: | 07/20/2005 |
| NPI Last Update Date: | 12/06/2012 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 208D00000X |
| License Number: | 30307 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | MO |
| Taxonomy Type: | Allopathic & Osteopathic Physicians |
| Taxonomy Classification: | General Practice |
| Taxonomy Specialization: | |
| Taxonomy Definition: | |