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NPI Code Detail

MEDICARE: DR. SAWYER JACOB BURGENER OTD

MEDICARE: DR. SAWYER JACOB BURGENER OTD
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1225XP0200XPediatric Occupational TherapistAR

General Provider Information

NPI Number : 1518564939
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. SAWYER JACOB BURGENER OTD
Provider Business Mailing Address
First Line : 275 BRATTON DR
Second Line :
City : HOT SPRINGS
State : AR
Zip : 71901-8659
Country : US
Telephone Number : 501-276-5064
Fax Number :
Provider Business Practice Location Address
First Line : 185 CORNERSTONE LN
Second Line :
City : HOT SPRINGS
State : AR
Zip : 71913-6500
Country : US
Telephone Number : 501-520-0660
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/08/2020
Last Update Date : 10/08/2020

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