Provider Demographics
NPI:1629486154
Name:SIGOLOFF, SAMUEL NELSON (DO)
Entity type:Individual
Prefix:DR
First Name:SAMUEL
Middle Name:NELSON
Last Name:SIGOLOFF
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:4990 E MEDITERRANEAN DR
Mailing Address - Street 2:
Mailing Address - City:SIERRA VISTA
Mailing Address - State:AZ
Mailing Address - Zip Code:85635-2494
Mailing Address - Country:US
Mailing Address - Phone:520-439-5186
Mailing Address - Fax:
Practice Address - Street 1:4990 E MEDITERRANEAN DR
Practice Address - Street 2:
Practice Address - City:SIERRA VISTA
Practice Address - State:AZ
Practice Address - Zip Code:85635-2494
Practice Address - Country:US
Practice Address - Phone:520-439-5186
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-07-29
Last Update Date:2024-05-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE1149207Q00000X
TXS3747207Q00000X
AZ010671207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine