Provider Demographics
NPI:1356419840
Name:SARTORE, J CHRISTOPHER (MD)
Entity type:Individual
Prefix:
First Name:J
Middle Name:CHRISTOPHER
Last Name:SARTORE
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 1:1137 W MILL RD
Mailing Address - Street 2:
Mailing Address - City:EVANSVILLE
Mailing Address - State:IN
Mailing Address - Zip Code:47710-3807
Mailing Address - Country:US
Mailing Address - Phone:812-426-9565
Mailing Address - Fax:812-426-9572
Practice Address - Street 1:1137 W MILL RD
Practice Address - Street 2:
Practice Address - City:EVANSVILLE
Practice Address - State:IN
Practice Address - Zip Code:47710-3807
Practice Address - Country:US
Practice Address - Phone:812-426-9565
Practice Address - Fax:812-426-9572
Is Sole Proprietor?:No
Enumeration Date:2006-12-01
Last Update Date:2008-12-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN01037761207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN000000109400OtherANTHEM
IN100331760Medicaid
KY64876394OtherKY MEDICAID
IN257900CCCMedicare PIN
IN000000109400OtherANTHEM
IND95667Medicare UPIN
IN100331760Medicaid