Provider Demographics
NPI:1841787595
Name:SABIN, MARK DANIEL (DO)
Entity Type:Individual
Prefix:
First Name:MARK
Middle Name:DANIEL
Last Name:SABIN
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 912042
Mailing Address - Street 2:
Mailing Address - City:ST GEORGE
Mailing Address - State:UT
Mailing Address - Zip Code:84791-2042
Mailing Address - Country:US
Mailing Address - Phone:435-215-0230
Mailing Address - Fax:
Practice Address - Street 1:630 E 1400 N STE 135
Practice Address - Street 2:
Practice Address - City:LOGAN
Practice Address - State:UT
Practice Address - Zip Code:84341-2549
Practice Address - Country:US
Practice Address - Phone:435-787-8146
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-04-18
Last Update Date:2023-08-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ009506207L00000X
UT8017686-1204207LP2900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207LP2900XAllopathic & Osteopathic PhysiciansAnesthesiologyPain Medicine
No207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology