MEDICARE: SARAH RENEE HART 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	208000000X	Pediatrics Physician	39947	KY

General Provider Information

NPI Number	:	1619993466
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SARAH RENEE HART M.D.

Provider Business Mailing Address
First Line	:	1707 CEDAR GROVE RD
Second Line	:	20
City	:	SHEPHERDSVILLE
State	:	KY
Zip	:	40165-8572
Country	:	US
Telephone Number	:	502-215-5090
Fax Number	:

Provider Business Practice Location Address
First Line	:	1707 CEDAR GROVE RD
Second Line	:	20
City	:	SHEPHERDSVILLE
State	:	KY
Zip	:	40165-8572
Country	:	US
Telephone Number	:	502-215-5090
Fax Number	:

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

Provider Enumeration Date	:	07/14/2006
Last Update Date	:	01/06/2011

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