Healthcare Provider Details
I. General information
NPI: 1497749188
Provider Name (Legal Business Name): KIMBERLEY E. SABEY D.O.
Entity Type: Individual
Gender: Female
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 09/08/2005
Last Update Date: 08/01/2008
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
1040 DIVISION ST
MAUSTON WI
53948-1931
US
IV. Provider business mailing address
1040 DIVISION ST
MAUSTON WI
53948-1931
US
V. Phone/Fax
- Phone: 608-847-9755
- Fax:
- Phone: 608-847-9755
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207Q00000X |
| Taxonomy | Family Medicine Physician |
| License Number | 45615 |
| License Number State | WI |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: