Provider Demographics
NPI:1437194024
Name:SARTORIS, ROBERT (OD)
Entity Type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:
Last Name:SARTORIS
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:325 33RD AVE N
Mailing Address - Street 2:SUITE 102
Mailing Address - City:SAINT CLOUD
Mailing Address - State:MN
Mailing Address - Zip Code:56303-3041
Mailing Address - Country:US
Mailing Address - Phone:320-251-8061
Mailing Address - Fax:320-202-8031
Practice Address - Street 1:325 33RD AVE N
Practice Address - Street 2:SUITE 102
Practice Address - City:SAINT CLOUD
Practice Address - State:MN
Practice Address - Zip Code:56303-3041
Practice Address - Country:US
Practice Address - Phone:320-251-8061
Practice Address - Fax:320-202-8031
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-18
Last Update Date:2008-04-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN1560152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN7449OtherHEALTH PARTNERS
MNT66090OtherUPIN
MN989370643001OtherPREFERRED ONE
MN2220114OtherMEDICA
MN0N501SAOtherBCBS
MNT66090OtherSELECT CARE
MN110955OtherUCARE
MN4C751SAOtherBLUE PLUS GLASSES
MN66G01SAOtherBCBS
MN381323100Medicaid
MN7449OtherHEALTH PARTNERS