Healthcare Provider Details

I. General information

NPI: 1982754974
Provider Name (Legal Business Name): JARRED L SARTAIN M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/11/2007
Last Update Date: 05/05/2023
Certification Date: 05/05/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

200 CARRAWAY DR STE B2
WINFIELD AL
35594-5072
US

IV. Provider business mailing address

5005 OSCAR BAXTER DR
TUSCALOOSA AL
35405-3698
US

V. Phone/Fax

Practice location:
  • Phone: 205-487-7556
  • Fax: 205-487-7559
Mailing address:
  • Phone: 250-343-2205
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number27658
License Number StateAL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: