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Individual

ERIC RICHMOND SARGENT

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
111 COLCHESTER AVENUE, EAST PAVILION 5, BURLINGTON, VT 05401
(802) 847-2884
(802) 847-6020
Mailing address
111 COLCHESTER AVENUE, BURLINGTON, VT 05401
(802) 847-2884
(802) 847-6020

Taxonomy

Speciality
Code
Description
License number
State
208800000X
Urology Physician
Primary
0420010146
VT
208800000X
Urology Physician
26588
IA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
01786350
NY
05
0VN2503
VT
05
1023011517
IA
05
209143403
MO
01
37456
BLUE CROSS BLUE SHIELD
01
42143522520
JOHN DEERE
01
421435525
TRI-CARE GROUP NUMBER
01
71754
WELLMARK/BLUE CROSS/BLUE
IA
01
G87836
CALIFORNIA LIC
CA
Enumeration date
05/27/2005
Last updated
11/19/2014
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