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General NPI Number Information
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NPI Number | 1609239763
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Entity Type | Individual
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Provider Name | SARAH KHAYAT M.D.
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Gender | Female
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Dates
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Enumeration Date | 04/05/2016
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Last Update Date | 01/31/2023
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Provider Practice Location Address
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Address Line | 3920 DUTCHMANS LN STE 308
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City | LOUISVILLE
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State | KY
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Zip | 40207-4702
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Country | US
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Telephone | 502-583-3687
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Fax |
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Provider Business Mailing Address
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Address Line | 196 W VINE ST APT A413
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City | SALT LAKE CITY
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State | UT
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Zip | 84107-5245
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Country | US
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Telephone | 502-644-3622
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207YS0123X
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Taxonomy Name | Facial Plastic Surgery Physician
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License Number | 12258150-1205
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License Number State | UT
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