Healthcare Provider Details

I. General information

NPI: 1811391469
Provider Name (Legal Business Name): SARAH E ZANGER PA-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: MISS SARAH E. BISHOP

II. Dates (important events)

Enumeration Date: 10/10/2014
Last Update Date: 10/21/2024
Certification Date: 10/21/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3101 POPLAR LEVEL RD STE 101
LOUISVILLE KY
40213-1076
US

IV. Provider business mailing address

PO BOX 776351
CHICAGO IL
60677-6351
US

V. Phone/Fax

Practice location:
  • Phone: 502-636-7444
  • Fax: 502-636-7112
Mailing address:
  • Phone: 502-588-9490
  • Fax: 502-272-5116

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License NumberPA1913
License Number StateKY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: