Provider Demographics
NPI:1497319297
Name:HART, SARA (APRN)
Entity Type:Individual
Prefix:
First Name:SARA
Middle Name:
Last Name:HART
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:420 W STONEWOOD DRIVE
Mailing Address - Street 2:
Mailing Address - City:BROKEN ARROW
Mailing Address - State:OK
Mailing Address - Zip Code:74012-1845
Mailing Address - Country:US
Mailing Address - Phone:918-872-8822
Mailing Address - Fax:918-872-8823
Practice Address - Street 1:420 W. STONE WOOD DRIVE
Practice Address - Street 2:
Practice Address - City:BROKEN ARROW
Practice Address - State:OK
Practice Address - Zip Code:74012
Practice Address - Country:US
Practice Address - Phone:918-872-8822
Practice Address - Fax:918-872-8823
Is Sole Proprietor?:No
Enumeration Date:2019-04-26
Last Update Date:2020-05-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK120198207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine