Healthcare Provider Details

I. General information

NPI: 1932155785
Provider Name (Legal Business Name): SARAH R DAVIS PA-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/25/2006
Last Update Date: 05/17/2023
Certification Date: 05/17/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10101 N 92ND ST STE 101
SCOTTSDALE AZ
85258-4553
US

IV. Provider business mailing address

10101 N 92ND ST STE 101
SCOTTSDALE AZ
85258-4553
US

V. Phone/Fax

Practice location:
  • Phone: 480-747-6532
  • Fax: 480-889-6865
Mailing address:
  • Phone: 480-747-6532
  • Fax: 480-889-6865

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License NumberPA07842
License Number StateTX
# 2
Primary TaxonomyN
Taxonomy Code363AM0700X
TaxonomyMedical Physician Assistant
License Number8237
License Number StateAZ
# 3
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number8237
License Number StateAZ
# 4
Primary TaxonomyN
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number12503
License Number StateMN
# 5
Primary TaxonomyN
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number003988
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: