Provider Demographics
NPI:1508824228
Name:OLAUGHLIN, SABINE R (MD)
Entity Type:Individual
Prefix:
First Name:SABINE
Middle Name:R
Last Name:OLAUGHLIN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 741087
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30384-1087
Mailing Address - Country:US
Mailing Address - Phone:386-326-8400
Mailing Address - Fax:386-326-8405
Practice Address - Street 1:800 PRUDENTIAL DR
Practice Address - Street 2:
Practice Address - City:JACKSONVILLE
Practice Address - State:FL
Practice Address - Zip Code:32207
Practice Address - Country:US
Practice Address - Phone:904-202-1347
Practice Address - Fax:904-202-3232
Is Sole Proprietor?:No
Enumeration Date:2006-05-02
Last Update Date:2017-04-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME60593207ZP0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207ZP0102XAllopathic & Osteopathic PhysiciansPathologyAnatomic Pathology & Clinical Pathology
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL220010518OtherRAILROAD MEDICARE
FL220010518OtherRAILROAD MEDICARE