Provider Demographics
NPI:1306808043
Name:SAGER, JOHN L (MD)
Entity type:Individual
Prefix:
First Name:JOHN
Middle Name:L
Last Name:SAGER
Suffix:
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 1:2620 E. BARNETT ROAD
Mailing Address - Street 2:SUITE H
Mailing Address - City:MEDFORD
Mailing Address - State:OR
Mailing Address - Zip Code:97504
Mailing Address - Country:US
Mailing Address - Phone:541-789-8176
Mailing Address - Fax:541-789-2558
Practice Address - Street 1:595 N. MAIN STREET
Practice Address - Street 2:
Practice Address - City:ASHLAND
Practice Address - State:OR
Practice Address - Zip Code:97520
Practice Address - Country:US
Practice Address - Phone:541-482-5853
Practice Address - Fax:541-482-5124
Is Sole Proprietor?:Yes
Enumeration Date:2006-04-06
Last Update Date:2015-11-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORMD17878207P00000X, 207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
OR057492Medicaid
97520A012OtherCHAMPUS
023713000OtherBLUE CROSS BLUE SHIELD OF OREGON
930086138OtherRAILROAD MEDICARE
OR023507000OtherBC/BS OF OREGON
OR930091706OtherRAILROAD MEDICARE
F60655OtherPROVIDENCE HEALTH PLAN
F60655OtherGROUP HEALTH
XPY191030OtherMEDI CAL
F60655OtherPROVIDENCE HEALTH PLAN
OR930091706OtherRAILROAD MEDICARE
F60655Medicare UPIN
R105288Medicare PIN