Provider Demographics
NPI:1063292852
Name:SAGEOAK HEALTH PLLC
Entity type:Organization
Organization Name:SAGEOAK HEALTH PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:FREDRIC
Authorized Official - Middle Name:
Authorized Official - Last Name:REYELTS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:616-560-2861
Mailing Address - Street 1:7440 SUNFISH WOODS CT
Mailing Address - Street 2:
Mailing Address - City:ROCKFORD
Mailing Address - State:MI
Mailing Address - Zip Code:49341-7127
Mailing Address - Country:US
Mailing Address - Phone:616-560-2861
Mailing Address - Fax:
Practice Address - Street 1:7440 SUNFISH WOODS CT
Practice Address - Street 2:
Practice Address - City:ROCKFORD
Practice Address - State:MI
Practice Address - Zip Code:49341-7127
Practice Address - Country:US
Practice Address - Phone:616-560-2861
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-09-29
Last Update Date:2023-09-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty