1124089503 NPI number — STEPHEN T SAUTER DO

Table of content: STEPHEN T SAUTER DO (NPI 1124089503)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1124089503 NPI number — STEPHEN T SAUTER DO

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
SAUTER
Provider First Name:
STEPHEN
Provider Middle Name:
T
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
DO
Provider Gender Code:
M

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1124089503
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
03/09/2023
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
2006 FRANKLIN ST SE STE 200
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
HUNTSVILLE
Provider Business Mailing Address State Name:
AL
Provider Business Mailing Address Postal Code:
35801-4537
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
256-539-0457
Provider Business Mailing Address Fax Number:
256-365-0237

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
2006 FRANKLIN ST SE STE 200
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
HUNTSVILLE
Provider Business Practice Location Address State Name:
AL
Provider Business Practice Location Address Postal Code:
35801-4537
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
256-539-0457
Provider Business Practice Location Address Fax Number:
256-365-0237
Provider Enumeration Date:
03/28/2006

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 2085R0202X , with the licence number:  2479 , registered in the state of AL ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 2085R0202X , with the licence number: 0528428 , registered in the state of KS ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 2085R0202X , with the licence number: H0069823 , registered in the state of MD ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 262723 , issued by the state of ( AL ) . This identifiers is of the category "MEDICAID".
  • Identifier: 262800 , issued by the state of ( AL ) . This identifiers is of the category "MEDICAID".
  • Identifier: 262959 , issued by the state of ( AL ) . This identifiers is of the category "MEDICAID".
  • Identifier: 263620 , issued by the state of ( AL ) . This identifiers is of the category "MEDICAID".
  • Identifier: 262778 , issued by the state of ( AL ) . This identifiers is of the category "MEDICAID".
  • Identifier: 263689 , issued by the state of ( AL ) . This identifiers is of the category "MEDICAID".
  • Identifier: 262755 , issued by the state of ( AL ) . This identifiers is of the category "MEDICAID".
  • Identifier: 262688 , issued by the state of ( AL ) . This identifiers is of the category "MEDICAID".
  • Identifier: 262695 , issued by the state of ( AL ) . This identifiers is of the category "MEDICAID".
  • Identifier: 262699 , issued by the state of ( AL ) . This identifiers is of the category "MEDICAID".
  • Identifier: 263161 , issued by the state of ( AL ) . This identifiers is of the category "MEDICAID".
  • Identifier: 263295 , issued by the state of ( AL ) . This identifiers is of the category "MEDICAID".




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