Provider Demographics
NPI:1811995277
Name:SARGENT, CATHERINE M (DO)
Entity type:Individual
Prefix:
First Name:CATHERINE
Middle Name:M
Last Name:SARGENT
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2633 COMMONS BLVD STE 120
Mailing Address - Street 2:
Mailing Address - City:BEAVERCREEK
Mailing Address - State:OH
Mailing Address - Zip Code:45431-3827
Mailing Address - Country:US
Mailing Address - Phone:937-427-8912
Mailing Address - Fax:937-702-9041
Practice Address - Street 1:2633 COMMONS BLVD STE 120
Practice Address - Street 2:
Practice Address - City:BEAVERCREEK
Practice Address - State:OH
Practice Address - Zip Code:45431-3827
Practice Address - Country:US
Practice Address - Phone:937-427-8912
Practice Address - Fax:937-702-9041
Is Sole Proprietor?:No
Enumeration Date:2005-07-11
Last Update Date:2024-11-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH34007228S207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2591117OtherAETNA
OH34193580OtherTRICARE
OHP00026715OtherRR MEDICARE
OH000000204896OtherANTHEM
OH341935880036OtherCARESOURCE
OH2239607Medicaid
OH000000204896OtherANTHEM
OHH36540Medicare UPIN