Healthcare Provider Details

I. General information

NPI: 1477728343
Provider Name (Legal Business Name): SEAN HASKETT M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/23/2008
Last Update Date: 03/17/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1248 E 90 N STE 300
AMERICAN FORK UT
84003-2956
US

IV. Provider business mailing address

1248 E 90 N STE 300
AMERICAN FORK UT
84003-2956
US

V. Phone/Fax

Practice location:
  • Phone: 801-756-9635
  • Fax: 801-216-8357
Mailing address:
  • Phone: 801-756-9635
  • Fax: 801-216-8357

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License Number81074
License Number StateAZ
# 2
Primary TaxonomyY
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License Number6825294-1205
License Number StateUT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: