MEDICARE: DR. SARAH CAMP WILLARD M.D.

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	208600000X	Surgery Physician	ME71364	FL

General Provider Information

NPI Number	:	1518021781
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. SARAH CAMP WILLARD M.D.

Provider Business Mailing Address
First Line	:	2001 LAUREL AVE
Second Line	:	STE 204
City	:	KNOXVILLE
State	:	TN
Zip	:	37916-1864
Country	:	US
Telephone Number	:	407-423-5537
Fax Number	:	407-426-0576

Provider Business Practice Location Address
First Line	:	1802 BELLEVUE AVE
Second Line	:	SUITE NUMBER 101
City	:	ORLANDO
State	:	FL
Zip	:	32806-2933
Country	:	US
Telephone Number	:	407-423-5537
Fax Number	:	407-426-0576

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

Provider Enumeration Date	:	12/21/2006
Last Update Date	:	03/07/2023

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