Healthcare Provider Details

I. General information

NPI: 1023928298
Provider Name (Legal Business Name): MR. STEPHEN MATTHEW SARR
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/10/2026
Last Update Date: 09/10/2026
Certification Date: 09/10/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1 MEDICAL CENTER BLVD
COOKEVILLE TN
38501-4294
US

IV. Provider business mailing address

2523 CANDYLAND CIR
COOKEVILLE TN
38506-5000
US

V. Phone/Fax

Practice location:
  • Phone: 931-528-2541
  • Fax:
Mailing address:
  • Phone: 931-510-3523
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number36812
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: