Provider Demographics
NPI:1265453302
Name:SARAH BARKSDALE, MD, PA
Entity Type:Organization
Organization Name:SARAH BARKSDALE, MD, PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:SARAH
Authorized Official - Middle Name:KAY
Authorized Official - Last Name:BARKSDALE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:904-962-0342
Mailing Address - Street 1:377 8TH ST
Mailing Address - Street 2:
Mailing Address - City:ATLANTIC BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:32233-5435
Mailing Address - Country:US
Mailing Address - Phone:904-962-0342
Mailing Address - Fax:904-247-6851
Practice Address - Street 1:5008 MUSTANG RD
Practice Address - Street 2:
Practice Address - City:JACKSONVILLE
Practice Address - State:FL
Practice Address - Zip Code:32216-6028
Practice Address - Country:US
Practice Address - Phone:904-296-2333
Practice Address - Fax:904-296-8467
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-22
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME 88373207ZP0101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207ZP0101XAllopathic & Osteopathic PhysiciansPathologyAnatomic PathologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
G32967Medicare UPIN