Individual
ANDREW ROBERT SACKS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
3122 WILLOW CREEK RD, PRESCOTT, AZ 86301
(928) 445-7632
(928) 445-9283
Mailing address
6622 N 91ST AVE, STE 220, GLENDALE, AZ 85305-2569
(602) 759-6883
(602) 224-3358
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
005933
AZ
207RN0300X
Nephrology Physician
Primary
005933
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
816579
—
AZ
Enumeration date
06/30/2010
Last updated
06/26/2018
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