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NPI Code Detail

MEDICARE: SARAH MILLER DOUGHERTY PA-C

MEDICARE:   SARAH MILLER DOUGHERTY  PA-C
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
1363A00000XPhysician AssistantPA1818KY

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1881036259
Entity Type Code : Individual
Provider Name (Legal Business Name) : SARAH MILLER DOUGHERTY PA-C
Provider Business Mailing Address
First Line : 4071 TATES CREEK CENTRE DR STE 202
Second Line :
City : LEXINGTON
State : KY
Zip : 40517-3094
Country : US
Telephone Number : 859-226-0206
Fax Number : 859-226-0207
Provider Business Practice Location Address
First Line : 4071 TATES CREEK CENTRE DR STE 202
Second Line :
City : LEXINGTON
State : KY
Zip : 40517-3094
Country : US
Telephone Number : 859-226-0206
Fax Number : 859-226-0207
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/25/2013
Last Update Date : 10/11/2019

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Directions to “ SARAH MILLER DOUGHERTY PA-C” Practice Location

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