Provider Demographics
NPI:1174124432
Name:SADLER, STEPHEN BRIGGS SR
Entity type:Individual
Prefix:
First Name:STEPHEN
Middle Name:BRIGGS
Last Name:SADLER
Suffix:SR
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:855 N CHURCH ST
Mailing Address - Street 2:
Mailing Address - City:THOMASTON
Mailing Address - State:GA
Mailing Address - Zip Code:30286-3622
Mailing Address - Country:US
Mailing Address - Phone:706-648-2109
Mailing Address - Fax:706-648-2168
Practice Address - Street 1:855 N CHURCH ST
Practice Address - Street 2:
Practice Address - City:THOMASTON
Practice Address - State:GA
Practice Address - Zip Code:30286-3622
Practice Address - Country:US
Practice Address - Phone:706-648-2109
Practice Address - Fax:706-648-2168
Is Sole Proprietor?:Yes
Enumeration Date:2020-11-03
Last Update Date:2020-11-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARPH016928183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist