Provider Demographics
NPI:1144217167
Name:WAGERS, SARAH KATHERINE (MD)
Entity Type:Individual
Prefix:DR
First Name:SARAH
Middle Name:KATHERINE
Last Name:WAGERS
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:220 ABRAHAM FLEXNER WAY STE 300
Mailing Address - Street 2:
Mailing Address - City:LOUISVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40202-3826
Mailing Address - Country:US
Mailing Address - Phone:502-584-3376
Mailing Address - Fax:502-584-3480
Practice Address - Street 1:220 ABRAHAM FLEXNER WAY STE 300
Practice Address - Street 2:
Practice Address - City:LOUISVILLE
Practice Address - State:KY
Practice Address - Zip Code:40202-3826
Practice Address - Country:US
Practice Address - Phone:502-584-3376
Practice Address - Fax:502-584-3480
Is Sole Proprietor?:No
Enumeration Date:2005-10-04
Last Update Date:2010-02-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY35879208100000X
IN01052859A208100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & Rehabilitation
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN3326602Medicaid
KY64069099Medicaid
KY0078124Medicare PIN
IN243960QMedicare PIN
KY64069099Medicaid