Provider Demographics
NPI:1477790129
Name:SATERFIELD, MICAH (LPO, LPED, CP, BOCP)
Entity Type:Individual
Prefix:
First Name:MICAH
Middle Name:
Last Name:SATERFIELD
Suffix:
Gender:M
Credentials:LPO, LPED, CP, BOCP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3500 S 79TH ST STE A
Mailing Address - Street 2:
Mailing Address - City:FORT SMITH
Mailing Address - State:AR
Mailing Address - Zip Code:72903-6250
Mailing Address - Country:US
Mailing Address - Phone:479-484-1620
Mailing Address - Fax:479-484-1619
Practice Address - Street 1:3500 S 79TH ST STE A
Practice Address - Street 2:
Practice Address - City:FORT SMITH
Practice Address - State:AR
Practice Address - Zip Code:72903-6250
Practice Address - Country:US
Practice Address - Phone:479-484-1620
Practice Address - Fax:479-484-1619
Is Sole Proprietor?:No
Enumeration Date:2009-01-16
Last Update Date:2009-01-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AROPP00138222Z00000X, 224P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224P00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersProsthetist
No222Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOrthotist