MEDICARE: SARAH MARLENE DAVIS

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	390200000X	Student in an Organized Health Care Education/Training Program		AR

General Provider Information

NPI Number	:	1982568176
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SARAH MARLENE DAVIS

Provider Business Mailing Address
First Line	:	3474 E KIEHL AVE APT 7412
Second Line	:
City	:	SHERWOOD
State	:	AR
Zip	:	72120-3559
Country	:	US
Telephone Number	:	662-689-1410
Fax Number	:

Provider Business Practice Location Address
First Line	:	2900 HAWKINS DR
Second Line	:
City	:	SEARCY
State	:	AR
Zip	:	72143-4802
Country	:	US
Telephone Number	:	501-278-2800
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/11/2025
Last Update Date	:	12/11/2025

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