Provider Demographics
NPI:1336302660
Name:AUBUCHON, SARAH ELIZABETH (MD)
Entity Type:Individual
Prefix:DR
First Name:SARAH
Middle Name:ELIZABETH
Last Name:AUBUCHON
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:6526 LANSDOWNE AVE
Mailing Address - Street 2:
Mailing Address - City:SAINT LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63109-2654
Mailing Address - Country:US
Mailing Address - Phone:314-353-8777
Mailing Address - Fax:314-353-8772
Practice Address - Street 1:6526 LANSDOWNE AVE
Practice Address - Street 2:
Practice Address - City:SAINT LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63109-2654
Practice Address - Country:US
Practice Address - Phone:314-353-8777
Practice Address - Fax:314-353-8772
Is Sole Proprietor?:No
Enumeration Date:2008-07-07
Last Update Date:2021-11-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2011012159208000000X
MO2008017826208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO205607401Medicaid