Healthcare Provider Details

I. General information

NPI: 1922252345
Provider Name (Legal Business Name): SARAH RUPPENTHAL PA
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: SARAH JO WILSON PA-C

II. Dates (important events)

Enumeration Date: 11/12/2008
Last Update Date: 06/23/2025
Certification Date: 06/23/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

805 FARSON ST STE 117
BELPRE OH
45714-1000
US

IV. Provider business mailing address

416 COLEGATE DR BLDG 3
MARIETTA OH
45750-9549
US

V. Phone/Fax

Practice location:
  • Phone: 740-401-0033
  • Fax: 740-401-0039
Mailing address:
  • Phone: 740-374-3526
  • Fax: 740-374-3165

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number50.003365RX
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: