Provider Demographics
NPI:1316106529
Name:SARGENT, MICHAEL D (DO)
Entity type:Individual
Prefix:
First Name:MICHAEL
Middle Name:D
Last Name:SARGENT
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:616 10TH ST
Mailing Address - Street 2:
Mailing Address - City:PERRY
Mailing Address - State:IA
Mailing Address - Zip Code:50220-2221
Mailing Address - Country:US
Mailing Address - Phone:515-465-3553
Mailing Address - Fax:515-465-4319
Practice Address - Street 1:616 10TH ST
Practice Address - Street 2:
Practice Address - City:PERRY
Practice Address - State:IA
Practice Address - Zip Code:50220-2221
Practice Address - Country:US
Practice Address - Phone:515-465-3553
Practice Address - Fax:515-465-4319
Is Sole Proprietor?:No
Enumeration Date:2008-06-03
Last Update Date:2015-09-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IADO-04004207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine