Healthcare Provider Details

I. General information

NPI: 1326390741
Provider Name (Legal Business Name): SARAH SANDERS ECKLEY P.A.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: SARAH CAROLINE SANDERS P.A.

II. Dates (important events)

Enumeration Date: 10/09/2012
Last Update Date: 01/30/2024
Certification Date: 01/30/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1226 DANTIGNAC ST
AUGUSTA GA
30901-2788
US

IV. Provider business mailing address

PO BOX 2344
AUGUSTA GA
30903-2344
US

V. Phone/Fax

Practice location:
  • Phone: 706-922-0600
  • Fax: 706-922-0603
Mailing address:
  • Phone: 706-922-0600
  • Fax: 706-922-0603

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number006624
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: