Provider Demographics
NPI:1235491564
Name:OGLE, SARAH BETH (DO, MS)
Entity Type:Individual
Prefix:
First Name:SARAH
Middle Name:BETH
Last Name:OGLE
Suffix:
Gender:F
Credentials:DO, MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11909 N APOLLO WAY
Mailing Address - Street 2:
Mailing Address - City:HIGHLAND
Mailing Address - State:UT
Mailing Address - Zip Code:84003-3682
Mailing Address - Country:US
Mailing Address - Phone:623-688-6347
Mailing Address - Fax:
Practice Address - Street 1:700 W 800 N # 330
Practice Address - Street 2:
Practice Address - City:OREM
Practice Address - State:UT
Practice Address - Zip Code:84057-6301
Practice Address - Country:US
Practice Address - Phone:435-216-3590
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-06-12
Last Update Date:2021-11-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT12385920-12042086S0120X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2086S0120XAllopathic & Osteopathic PhysiciansSurgeryPediatric Surgery