Individual
JAMES SACKETT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.O
Contact information
Practice address
5486 YELLOW BIRCH WAY, INDIANAPOLIS, IN 46254-9636
(765) 864-8715
Mailing address
5486 YELLOW BIRCH WAY, INDIANAPOLIS, IN 46254-9636
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
02001549
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200056540
—
IN
01
—
P01270907
RR MEDICARE
IN
Enumeration date
11/02/2005
Last updated
03/17/2015
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