Healthcare Provider Details

I. General information

NPI: 1942829007
Provider Name (Legal Business Name): SARAH JO MACE DO
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/09/2020
Last Update Date: 10/17/2025
Certification Date: 10/17/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8402 HARCOURT RD STE 615
INDIANAPOLIS IN
46260-2055
US

IV. Provider business mailing address

6983 HILLSDALE CT
INDIANAPOLIS IN
46250-2054
US

V. Phone/Fax

Practice location:
  • Phone: 317-308-2800
  • Fax: 317-806-6990
Mailing address:
  • Phone: 317-308-2800
  • Fax: 317-576-6311

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084N0400X
TaxonomyNeurology Physician
License Number02007782A
License Number StateIN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: