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General NPI Number Information
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NPI Number | 1629230511
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Entity Type | Organization
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Legal Business Name | DAVID J SARGENT, MD, PC
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Dates
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Enumeration Date | 07/01/2008
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Last Update Date | 07/01/2008
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Provider Practice Location Address
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Address Line | 10101 SE MAIN ST SUITE 2015
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City | PORTLAND
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State | OR
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Zip | 97216-2455
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Country | US
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Telephone | 503-261-2977
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Fax | 503-261-0156
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Provider Business Mailing Address
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Address Line | 10101 SE MAIN ST SUITE 2015
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City | PORTLAND
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State | OR
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Zip | 97216-2455
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Country | US
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Telephone | 503-261-2977
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Fax | 503-261-0156
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Authorized Official
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Title or Position | OWNER
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Name | DAVID JAMES SARGENT
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Credential | MD
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Telephone | 503-261-2977
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number | MD12584
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License Number State | OR
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