MEDICARE: SANDRA LYNN SAVAGE DO

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207P00000X	Emergency Medicine Physician	03154	KY

General Provider Information

NPI Number	:	1346367331
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SANDRA LYNN SAVAGE DO

Provider Business Mailing Address
First Line	:	5200 COMMERCE CROSSING, 3RD FLOOR
Second Line	:	ATTN: PROVIDER ENROLLMENT
City	:	LOUISVILLE
State	:	KY
Zip	:	40229
Country	:	US
Telephone Number	:	502-253-4900
Fax Number	:

Provider Business Practice Location Address
First Line	:	1006 NEW MOODY LN FL 1
Second Line	:
City	:	LA GRANGE
State	:	KY
Zip	:	40031-9122
Country	:	US
Telephone Number	:	502-222-0028
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/23/2007
Last Update Date	:	12/02/2020

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