MEDICARE: SCOTT D. SADLER P.A.-C

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363AS0400X	Surgical Physician Assistant	2050	AZ

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1386612265
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SCOTT D. SADLER P.A.-C

Provider Business Mailing Address
First Line	:	P.O. BOX 790
Second Line	:
City	:	PAGE
State	:	AZ
Zip	:	86040-0790
Country	:	US
Telephone Number	:	928-645-0945
Fax Number	:	928-645-3254

Provider Business Practice Location Address
First Line	:	463 S LAKE POWELL BLVD
Second Line	:
City	:	PAGE
State	:	AZ
Zip	:	86040-0790
Country	:	US
Telephone Number	:	928-645-0945
Fax Number	:	928-645-3254

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/08/2006
Last Update Date	:	05/27/2011

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