Basic Information
| Provider Information | |||||||||
| NPI: | 1760472906 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | SADLER | ||||||||
| FirstName: | SCOTT | ||||||||
| MiddleName: | MICHAEL | ||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 294 SUMMAR DR | ||||||||
| Address2: | |||||||||
| City: | JACKSON | ||||||||
| State: | TN | ||||||||
| PostalCode: | 383013915 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7314231932 | ||||||||
| FaxNumber: | 7314100367 | ||||||||
| Practice Location | |||||||||
| Address1: | 294 SUMMAR DR | ||||||||
| Address2: | |||||||||
| City: | JACKSON | ||||||||
| State: | TN | ||||||||
| PostalCode: | 383013915 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7314231932 | ||||||||
| FaxNumber: | 7314100367 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 10/27/2005 | ||||||||
| LastUpdateDate: | 01/27/2011 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207Q00000X | 30952 | TN | Y | Allopathic & Osteopathic Physicians | Family Medicine |
ID Information
| ID | Type | State | Issuer | Description | 27437 | 01 | TN | TLC | OTHER | 3432488 | 05 | TN | MEDICAID | 626001636 | 01 | TN | HEALTH PARTNERS | OTHER | 3832482 | 05 | TN | MEDICAID | 4055373 | 01 | TN | BLUE CROSS BLUE SHIELD | OTHER | P00034972 | 01 | TN | RAILROAD MEDICARE | OTHER | 626001636 | 01 | TN | USA MANAGED CARE | OTHER | 626001636 | 01 | TN | UNITED HEALTHCARE | OTHER | 152665 | 01 | TN | UNISON | OTHER | 4625281 | 01 | TN | CIGNA | OTHER |