Healthcare Provider Details

I. General information

NPI: 1801930862
Provider Name (Legal Business Name): SARA BARR PA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/16/2007
Last Update Date: 03/26/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3850 PLEASANT HILL RD
DULUTH GA
30096-4807
US

IV. Provider business mailing address

3850 PLEASANT HILL RD
DULUTH GA
30096-4807
US

V. Phone/Fax

Practice location:
  • Phone: 770-814-8222
  • Fax: 678-205-5111
Mailing address:
  • Phone: 770-814-8222
  • Fax: 678-205-5111

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363AM0700X
TaxonomyMedical Physician Assistant
License Number4768
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: