Provider Demographics
NPI:1316927403
Name:SADLER, JERRY DON (MD)
Entity type:Individual
Prefix:DR
First Name:JERRY
Middle Name:DON
Last Name:SADLER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:3409 ELM SPRINGS RD
Mailing Address - Street 2:
Mailing Address - City:SPRINGDALE
Mailing Address - State:AR
Mailing Address - Zip Code:72762-2754
Mailing Address - Country:US
Mailing Address - Phone:479-927-2100
Mailing Address - Fax:479-927-2211
Practice Address - Street 1:3409 ELM SPRINGS RD
Practice Address - Street 2:
Practice Address - City:SPRINGDALE
Practice Address - State:AR
Practice Address - Zip Code:72762-2754
Practice Address - Country:US
Practice Address - Phone:479-927-2100
Practice Address - Fax:479-927-2211
Is Sole Proprietor?:No
Enumeration Date:2006-01-17
Last Update Date:2011-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARE-6135207Q00000X
LAMD.024617207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
AR5H506OtherAR BC/BS