Haggenjos, Mark Allen

Haggenjos, Mark Allen is an individual health care provider with primary practice located at 428 West Votaw Street Suite A, Portland IN 47371-0710. He recently has 3 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Emergency Medicine, Allopathic & Osteopathic Physicians / Hospitalist, Allopathic & Osteopathic Physicians / Family Medicine. Allopathic & Osteopathic Physicians / Family Medicine is his primary health care specialty. Haggenjos, Mark Allen can be contacted via phone (260) 726-8822.

Contact Information

Primary practice address
428 West Votaw Street Suite A Portland IN 47371-0710
Phone: (260) 726-8822
Fax: (260) 726-7857
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Emergency Medicine 207P00000X 02001027A Indiana
Allopathic & Osteopathic Physicians / Hospitalist 208M00000X 02001027A Indiana
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X 02001027A Indiana

Profile Details

NPI number 1619935475
LBN Legal business name Haggenjos, Mark Allen
Credentials Doctor of Osteopathy (DO)
Entity Individual
Sole proprietor 1 No
Enumeration date May 2nd, 2006
Last updated Jan 8th, 2021 - about 5 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1619935475 NPPES
Indiana MEDICAID 100348680

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