Healthcare Provider Details

I. General information

NPI: 1427966043
Provider Name (Legal Business Name): SARAH BAWCUM
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

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

III. Provider practice location address

9550 HIGHWAY 412 W
LEXINGTON TN
38351-5849
US

IV. Provider business mailing address

257 BANCORP SOUTH PKWY
JACKSON TN
38305-7582
US

V. Phone/Fax

Practice location:
  • Phone: 731-967-3224
  • Fax: 731-968-3305
Mailing address:
  • Phone: 731-660-8781
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number17292
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: