Provider Demographics
NPI:1063502383
Name:SAPPINGTON, ANDREW ARNOLD III (PSYCHOLOGIST)
Entity Type:Individual
Prefix:MR
First Name:ANDREW
Middle Name:ARNOLD
Last Name:SAPPINGTON
Suffix:III
Gender:M
Credentials:PSYCHOLOGIST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Mailing Address - Street 1:1100 S PONCE DE LEON BLVD STE 1
Mailing Address - Street 2:
Mailing Address - City:SAINT AUGUSTINE
Mailing Address - State:FL
Mailing Address - Zip Code:32084-6013
Mailing Address - Country:US
Mailing Address - Phone:904-824-7733
Mailing Address - Fax:904-829-9768
Practice Address - Street 1:1100 S PONCE DE LEON BLVD STE 1
Practice Address - Street 2:
Practice Address - City:SAINT AUGUSTINE
Practice Address - State:FL
Practice Address - Zip Code:32084-6013
Practice Address - Country:US
Practice Address - Phone:904-824-7733
Practice Address - Fax:904-829-9768
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-15
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL5706103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL75181ZMedicare ID - Type Unspecified