Provider Demographics
NPI:1811570567
Name:SAUCER, DESHIA R
Entity Type:Individual
Prefix:
First Name:DESHIA
Middle Name:R
Last Name:SAUCER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2495 TURTLE TER
Mailing Address - Street 2:
Mailing Address - City:GRAYSON
Mailing Address - State:GA
Mailing Address - Zip Code:30017-2832
Mailing Address - Country:US
Mailing Address - Phone:470-304-5844
Mailing Address - Fax:
Practice Address - Street 1:2495 TURTLE TER
Practice Address - Street 2:
Practice Address - City:GRAYSON
Practice Address - State:GA
Practice Address - Zip Code:30017-2832
Practice Address - Country:US
Practice Address - Phone:470-304-5844
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-04-30
Last Update Date:2021-04-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes246R00000XTechnologists, Technicians & Other Technical Service ProvidersTechnician, Pathology