MEDICARE: SARA ELIZABETH WALKER MD

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	207QS0010X	Sports Medicine (Family Medicine) Physician	287262	MA

General Provider Information

NPI Number	:	1871090555
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SARA ELIZABETH WALKER MD

Provider Business Mailing Address
First Line	:	2870 E 3300 S
Second Line	:
City	:	SALT LAKE CITY
State	:	UT
Zip	:	84109-2821
Country	:	US
Telephone Number	:	385-500-3300
Fax Number	:	385-242-7975

Provider Business Practice Location Address
First Line	:	2870 E 3300 S
Second Line	:
City	:	SALT LAKE CITY
State	:	UT
Zip	:	84109-2821
Country	:	US
Telephone Number	:	385-500-3300
Fax Number	:	385-242-7975

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

Provider Enumeration Date	:	04/10/2018
Last Update Date	:	06/16/2024

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