Provider Demographics
NPI:1235722380
Name:HUGHES, SARAHREAGAN TEPOOL (PA-C)
Entity Type:Individual
Prefix:MRS
First Name:SARAHREAGAN
Middle Name:TEPOOL
Last Name:HUGHES
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:SARAH
Other - Middle Name:REAGAN
Other - Last Name:TEPOOL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2100 16TH AVE S
Mailing Address - Street 2:
Mailing Address - City:BIRMINGHAM
Mailing Address - State:AL
Mailing Address - Zip Code:35205-5021
Mailing Address - Country:US
Mailing Address - Phone:256-468-7711
Mailing Address - Fax:
Practice Address - Street 1:4337 MOUNTAINDALE RD
Practice Address - Street 2:
Practice Address - City:BIRMINGHAM
Practice Address - State:AL
Practice Address - Zip Code:35213-1606
Practice Address - Country:US
Practice Address - Phone:256-468-7711
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-02-18
Last Update Date:2021-11-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ALPA.1738363A00000X, 363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical
No363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant