Healthcare Provider Details

I. General information

NPI: 1275326860
Provider Name (Legal Business Name): SARAH CHRISTINA HOSSACK DO
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/27/2025
Last Update Date: 05/27/2025
Certification Date: 05/12/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1469 LANEY WALKER BLVD
AUGUSTA GA
30912-0002
US

IV. Provider business mailing address

950 COMMON OAK PL
LAWRENCEVILLE GA
30045-8260
US

V. Phone/Fax

Practice location:
  • Phone: 706-721-7005
  • Fax:
Mailing address:
  • Phone: 917-515-7242
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number17738
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: