Individual
AUTUMN SACKLOW
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
140 ACADEMY ST # 10, PRESQUE ISLE, ME 04769-3102
(207) 764-6310
(207) 764-6993
Mailing address
129 WILLIAMS RD, PRESQUE ISLE, ME 04769-5266
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
MD27947
ME
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
03/22/2018
Last updated
06/27/2024
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