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General NPI Number Information
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NPI Number | 1902238843
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Entity Type | Individual
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Provider Name | SARAH ROMINES CLECKLER DO
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Gender | Female
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Dates
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Enumeration Date | 08/02/2013
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Last Update Date | 08/10/2021
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Provider Practice Location Address
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Address Line | 809 E MAIN ST
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City | BLUE RIDGE
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State | GA
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Zip | 30513-4575
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Country | US
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Telephone | 706-632-1155
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Fax |
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Provider Business Mailing Address
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Address Line | 346 DEEP SOUTH FARM RD STE A
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City | BLAIRSVILLE
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State | GA
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Zip | 30512-2218
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Country | US
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Telephone | 706-745-9417
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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 | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | OS14240
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License Number State | FL
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