Provider Demographics
NPI:1598827552
Name:WILLIAM O. SARGEANT PC
Entity Type:Organization
Organization Name:WILLIAM O. SARGEANT PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:WILLIAM
Authorized Official - Middle Name:O
Authorized Official - Last Name:SARGEANT
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:334-265-8455
Mailing Address - Street 1:1758 PARK PL STE 100
Mailing Address - Street 2:
Mailing Address - City:MONTGOMERY
Mailing Address - State:AL
Mailing Address - Zip Code:36106-1133
Mailing Address - Country:US
Mailing Address - Phone:334-265-8455
Mailing Address - Fax:334-265-8456
Practice Address - Street 1:1758 PARK PL
Practice Address - Street 2:SUITE 100
Practice Address - City:MONTGOMERY
Practice Address - State:AL
Practice Address - Zip Code:36106-1127
Practice Address - Country:US
Practice Address - Phone:334-265-8455
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-15
Last Update Date:2020-12-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
ALL084Medicare PIN
AL6462460001Medicare NSC