Healthcare Provider Details

I. General information

NPI: 1952171332
Provider Name (Legal Business Name): SARA JANE CARTER PA-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/05/2024
Last Update Date: 09/22/2026
Certification Date: 09/22/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3990 E BROAD ST BLDG 11
COLUMBUS OH
43213-1152
US

IV. Provider business mailing address

4166 STATE ROUTE 48
WEST MILTON OH
45383-1923
US

V. Phone/Fax

Practice location:
  • Phone: 614-336-7188
  • Fax:
Mailing address:
  • Phone: 937-216-9740
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number50.009434RX
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: