MEDICARE: ERIC A SADLER PA

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
1	363AS0400X	Surgical Physician Assistant
2	363AS0400X	Surgical Physician Assistant	68491	MT
3	363A00000X	Physician Assistant	10002141A	IN

General Provider Information

NPI Number	:	1629423041
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ERIC A SADLER PA

Provider Business Mailing Address
First Line	:	4015 GATEWAY BLVD
Second Line	:	STE 2120
City	:	NEWBURGH
State	:	IN
Zip	:	47630-9460
Country	:	US
Telephone Number	:	812-842-0907
Fax Number	:	812-464-4485

Provider Business Practice Location Address
First Line	:	4015 GATEWAY BLVD
Second Line	:	STE 2120
City	:	NEWBURGH
State	:	IN
Zip	:	47630-9460
Country	:	US
Telephone Number	:	812-842-0907
Fax Number	:	812-464-4485

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/04/2016
Last Update Date	:	08/23/2018

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Directions to “ ERIC A SADLER PA” Practice Location

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