MEDICARE: MATTHEW SARTIN MED., BCBA

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	103K00000X	Behavior Analyst	1-16-22398	CO

General Provider Information

NPI Number	:	1720556608
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MATTHEW SARTIN MED., BCBA

Provider Business Mailing Address
First Line	:	50 WILLOW OAK DR
Second Line	:
City	:	RICHMOND HILL
State	:	GA
Zip	:	31324-4066
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	639 JOHN CARTER RD
Second Line	:
City	:	BLOOMINGDALE
State	:	GA
Zip	:	31302-8065
Country	:	US
Telephone Number	:	912-321-3304
Fax Number	:

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

Provider Enumeration Date	:	11/08/2018
Last Update Date	:	11/08/2018

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Directions to “ MATTHEW SARTIN MED., BCBA” Practice Location

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