Healthcare Provider Details

I. General information

NPI: 1073781316
Provider Name (Legal Business Name): SARAH ELIZABETH CARNEY MED FAAA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: SARAH ELIZABETH CLARK

II. Dates (important events)

Enumeration Date: 02/20/2008
Last Update Date: 08/07/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11725 N ILLINOIS ST STE 445
CARMEL IN
46032-3008
US

IV. Provider business mailing address

PO BOX 6143
INDIANAPOLIS IN
46206-6143
US

V. Phone/Fax

Practice location:
  • Phone: 317-844-7059
  • Fax: 317-819-0044
Mailing address:
  • Phone: 317-844-7059
  • Fax: 317-819-0044

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code231H00000X
TaxonomyAudiologist
License Number23002489A
License Number StateIN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: