Provider Demographics
NPI:1306462502
Name:MCDOLE, SARA JEANNE (PA-C)
Entity type:Individual
Prefix:MRS
First Name:SARA
Middle Name:JEANNE
Last Name:MCDOLE
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:225 CENTRAL ST
Mailing Address - Street 2:
Mailing Address - City:HARRISVILLE
Mailing Address - State:RI
Mailing Address - Zip Code:02830-1536
Mailing Address - Country:US
Mailing Address - Phone:401-263-1829
Mailing Address - Fax:
Practice Address - Street 1:234 MAPLE AVE
Practice Address - Street 2:
Practice Address - City:BARRINGTON
Practice Address - State:RI
Practice Address - Zip Code:02806-3406
Practice Address - Country:US
Practice Address - Phone:401-247-1644
Practice Address - Fax:401-247-4961
Is Sole Proprietor?:No
Enumeration Date:2020-06-23
Last Update Date:2023-03-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
363A00000X
RIPA012332080A0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080A0000XAllopathic & Osteopathic PhysiciansPediatricsAdolescent Medicine
No363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant