Healthcare Provider Details

I. General information

NPI: 1306010764
Provider Name (Legal Business Name): JOHN E SATTENSPIEL M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/16/2008
Last Update Date: 04/16/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1800 MILLRACE DR
EUGENE OR
97403-1992
US

IV. Provider business mailing address

1800 MILLRACE DR
EUGENE OR
97403-1992
US

V. Phone/Fax

Practice location:
  • Phone: 541-485-2155
  • Fax:
Mailing address:
  • Phone: 541-485-2155
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number12391
License Number StateOR

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: