Provider Demographics
NPI:1477728343
Name:HASKETT, SEAN (MD)
Entity Type:Individual
Prefix:DR
First Name:SEAN
Middle Name:
Last Name:HASKETT
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 1:1248 E 90 N
Mailing Address - Street 2:STE 300
Mailing Address - City:AMERICAN FORK
Mailing Address - State:UT
Mailing Address - Zip Code:84003-2956
Mailing Address - Country:US
Mailing Address - Phone:801-756-9635
Mailing Address - Fax:801-216-8357
Practice Address - Street 1:1248 E 90 N
Practice Address - Street 2:STE 300
Practice Address - City:AMERICAN FORK
Practice Address - State:UT
Practice Address - Zip Code:84003-2956
Practice Address - Country:US
Practice Address - Phone:801-756-9635
Practice Address - Fax:801-216-8357
Is Sole Proprietor?:No
Enumeration Date:2008-04-23
Last Update Date:2017-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ81074207V00000X
UT6825294-1205207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ81074OtherTRAINING PERMIT
UT000063909Medicare PIN