Individual
DR. LARRY A SARGENT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
620 MEDICAL DR, SUITE 310, BOUNTIFUL, UT 84010-5084
(801) 295-6554
(801) 294-4983
Mailing address
620 MEDICAL DR, SUITE 310, BOUNTIFUL, UT 84010-5084
(801) 295-6554
(801) 294-4983
Taxonomy
Speciality
Code
Description
License number
State
2082S0099X
Plastic Surgery Within the Head and Neck (Plastic Surgery) Physician
18170
TN
2086S0122X
Plastic and Reconstructive Surgery Physician
Primary
18170
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000348466A
—
TN
01
—
0151430
BCBS
TN
01
—
1114640001
PALMETTO DME
TN
01
—
1348074
UNITED HEALTHCARE INS.
TN
01
—
2006636
BCBS GROUP
TN
01
—
240004378
RAILROAD MEDICARE
TN
01
—
PLF03906636
CHAMPUS
TN
01
—
TN0105
JOHN DEERE INS.
TN
Enumeration date
03/03/2006
Last updated
10/17/2016
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