Provider Demographics
NPI:1326087909
Name:AYRES, SARAH ELIZABETH (MD)
Entity Type:Individual
Prefix:DR
First Name:SARAH
Middle Name:ELIZABETH
Last Name:AYRES
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:105 S BRYANT AVE
Mailing Address - Street 2:SUITE 306
Mailing Address - City:EDMOND
Mailing Address - State:OK
Mailing Address - Zip Code:73034-6399
Mailing Address - Country:US
Mailing Address - Phone:405-340-8918
Mailing Address - Fax:405-340-0960
Practice Address - Street 1:105 S BRYANT AVE
Practice Address - Street 2:SUITE 306
Practice Address - City:EDMOND
Practice Address - State:OK
Practice Address - Zip Code:73034-6399
Practice Address - Country:US
Practice Address - Phone:405-340-8918
Practice Address - Fax:405-340-0960
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-06
Last Update Date:2009-12-03
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
OK8942207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
OK730780621OtherFEDERAL TAX ID
OK100165040Medicaid
OK100165040Medicaid