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NPI Code Detail

MEDICARE: SARAH LISTON DO

MEDICARE: SARAH LISTON 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
12084N0400XNeurology PhysicianMED-PHYS-LIC-124855MT
22084N0400XNeurology Physician14288642-1204UT

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1942863634
Entity Type Code : Individual
Provider Name (Legal Business Name) : SARAH LISTON DO
Provider Business Mailing Address
First Line : PO BOX 27128
Second Line :
City : SALT LAKE CITY
State : UT
Zip : 84127-0128
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 1350 N 500 E
Second Line :
City : LOGAN
State : UT
Zip : 84341-2400
Country : US
Telephone Number : 435-716-1980
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/17/2019
Last Update Date : 06/02/2026

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Directions to “ SARAH LISTON DO” Practice Location

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