Provider Demographics
NPI:1396228177
Name:THE AXON GROUP, LTD.
Entity Type:Organization
Organization Name:THE AXON GROUP, LTD.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:KAREN
Authorized Official - Middle Name:
Authorized Official - Last Name:SARPOLIS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:215-779-7392
Mailing Address - Street 1:295 E SWEDESFORD RD # 254
Mailing Address - Street 2:
Mailing Address - City:WAYNE
Mailing Address - State:PA
Mailing Address - Zip Code:19087-1462
Mailing Address - Country:US
Mailing Address - Phone:215-779-7392
Mailing Address - Fax:
Practice Address - Street 1:700 E BEARDSLEY AVE STE 100
Practice Address - Street 2:
Practice Address - City:ELKHART
Practice Address - State:IN
Practice Address - Zip Code:46514-3365
Practice Address - Country:US
Practice Address - Phone:574-206-8010
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-09-08
Last Update Date:2018-09-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN01040395A207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency MedicineGroup - Single Specialty