Provider Demographics
NPI:1376839407
Name:LIGHTHIZER, SARAH SERVINSKY (DO)
Entity Type:Individual
Prefix:
First Name:SARAH
Middle Name:SERVINSKY
Last Name:LIGHTHIZER
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:265 FREMONT ST STE 1
Mailing Address - Street 2:
Mailing Address - City:BATTLE CREEK
Mailing Address - State:MI
Mailing Address - Zip Code:49017-3354
Mailing Address - Country:US
Mailing Address - Phone:269-962-6221
Mailing Address - Fax:
Practice Address - Street 1:265 FREMONT ST STE 1
Practice Address - Street 2:
Practice Address - City:BATTLE CREEK
Practice Address - State:MI
Practice Address - Zip Code:49017-3354
Practice Address - Country:US
Practice Address - Phone:269-962-6221
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-06-27
Last Update Date:2023-11-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5315051206208000000X
MI5101019484208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics