Provider Demographics
NPI:1497079933
Name:STORY, SARA K (MD)
Entity Type:Individual
Prefix:
First Name:SARA
Middle Name:K
Last Name:STORY
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:79 WOODGROVE DR
Mailing Address - Street 2:
Mailing Address - City:JACKSON
Mailing Address - State:TN
Mailing Address - Zip Code:38305-6450
Mailing Address - Country:US
Mailing Address - Phone:502-320-8177
Mailing Address - Fax:
Practice Address - Street 1:620 SKYLINE DR
Practice Address - Street 2:
Practice Address - City:JACKSON
Practice Address - State:TN
Practice Address - Zip Code:38301-3923
Practice Address - Country:US
Practice Address - Phone:731-541-4923
Practice Address - Fax:731-660-8739
Is Sole Proprietor?:No
Enumeration Date:2010-03-25
Last Update Date:2024-03-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MS27724207R00000X
ARE-13939207R00000X
TN53449207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine