Provider Demographics
NPI:1215923578
Name:SAQUETON, ANTONIO B JR (MD)
Entity type:Individual
Prefix:DR
First Name:ANTONIO
Middle Name:B
Last Name:SAQUETON
Suffix:JR
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4951 CENTER ST
Mailing Address - Street 2:STE 100
Mailing Address - City:OMAHA
Mailing Address - State:NE
Mailing Address - Zip Code:68106-3252
Mailing Address - Country:US
Mailing Address - Phone:402-556-9220
Mailing Address - Fax:
Practice Address - Street 1:4951 CENTER ST
Practice Address - Street 2:SUITE 100
Practice Address - City:OMAHA
Practice Address - State:NE
Practice Address - Zip Code:68106-3251
Practice Address - Country:US
Practice Address - Phone:402-556-9220
Practice Address - Fax:
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-09-22
Last Update Date:2017-08-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE19126207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NEG22345Medicare UPIN