Provider Demographics
NPI:1154702892
Name:JEFFREY A SWEAT MD PC
Entity type:Organization
Organization Name:JEFFREY A SWEAT MD PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DOCTOR OF MEDICINE
Authorized Official - Prefix:DR
Authorized Official - First Name:JEFFREY
Authorized Official - Middle Name:AARON
Authorized Official - Last Name:SWEAT
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:916-925-3912
Mailing Address - Street 1:83 SCRIPPS DR
Mailing Address - Street 2:SUITE 130
Mailing Address - City:SACRAMENTO
Mailing Address - State:CA
Mailing Address - Zip Code:95825-6319
Mailing Address - Country:US
Mailing Address - Phone:916-925-3912
Mailing Address - Fax:
Practice Address - Street 1:83 SCRIPPS DR
Practice Address - Street 2:SUITE 130
Practice Address - City:SACRAMENTO
Practice Address - State:CA
Practice Address - Zip Code:95825-6319
Practice Address - Country:US
Practice Address - Phone:916-925-3912
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-06-17
Last Update Date:2015-06-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA952932086S0122X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2086S0122XAllopathic & Osteopathic PhysiciansSurgeryPlastic and Reconstructive SurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA13526460OtherCAQH ID