Healthcare Provider Details

I. General information

NPI: 1306855978
Provider Name (Legal Business Name): SARAH LYN ASHBY M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/05/2006
Last Update Date: 10/06/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1159 E 200 N STE 200
AMERICAN FORK UT
84003-2022
US

IV. Provider business mailing address

1159 E 200 N STE 200
AMERICAN FORK UT
84003-2022
US

V. Phone/Fax

Practice location:
  • Phone: 801-756-5609
  • Fax: 801-756-5200
Mailing address:
  • Phone: 801-756-5609
  • Fax: 801-756-5200

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberA93953
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number7625419-1205
License Number StateUT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: