Healthcare Provider Details

I. General information

NPI: 1528363827
Provider Name (Legal Business Name): SARA JEAN ENYART PA-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: SARA UPDIKE

II. Dates (important events)

Enumeration Date: 01/18/2011
Last Update Date: 05/30/2026
Certification Date: 05/30/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

518 W WILL ROGERS BLVD
CLAREMORE OK
74017-6823
US

IV. Provider business mailing address

PO BOX 3263
CLAREMORE OK
74018-3263
US

V. Phone/Fax

Practice location:
  • Phone: 918-205-2685
  • Fax: 918-727-2652
Mailing address:
  • Phone: 918-205-2685
  • Fax: 918-727-2652

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number1993
License Number StateOK

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: