Provider Demographics
NPI:1073614608
Name:SARGENT, RICHARD PAUL (MD)
Entity Type:Individual
Prefix:DR
First Name:RICHARD
Middle Name:PAUL
Last Name:SARGENT
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 1:820 N MONTANA AVE
Mailing Address - Street 2:SAGE MEDICAL CLINIC
Mailing Address - City:HELENA
Mailing Address - State:MT
Mailing Address - Zip Code:59601-3856
Mailing Address - Country:US
Mailing Address - Phone:406-443-7733
Mailing Address - Fax:406-443-8292
Practice Address - Street 1:820 N MONTANA AVE
Practice Address - Street 2:SAGE MEDICAL CLINIC
Practice Address - City:HELENA
Practice Address - State:MT
Practice Address - Zip Code:59601-3856
Practice Address - Country:US
Practice Address - Phone:406-443-7733
Practice Address - Fax:406-443-8292
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-26
Last Update Date:2010-12-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MT6901207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MT903110OtherBCBSMT
MT0141712Medicaid
MTC47899Medicare UPIN
MT000084682Medicare ID - Type Unspecified