Provider Demographics
NPI:1578787800
Name:HORNBEIN, SARA LYNN (MD)
Entity Type:Individual
Prefix:
First Name:SARA
Middle Name:LYNN
Last Name:HORNBEIN
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 1:2741 DEBARR RD
Mailing Address - Street 2:SUITE C-308
Mailing Address - City:ANCHORAGE
Mailing Address - State:AK
Mailing Address - Zip Code:99508-2953
Mailing Address - Country:US
Mailing Address - Phone:907-272-3366
Mailing Address - Fax:907-272-0269
Practice Address - Street 1:2741 DEBARR RD
Practice Address - Street 2:SUITE C-308
Practice Address - City:ANCHORAGE
Practice Address - State:AK
Practice Address - Zip Code:99508-2953
Practice Address - Country:US
Practice Address - Phone:907-272-3366
Practice Address - Fax:907-272-0269
Is Sole Proprietor?:No
Enumeration Date:2007-04-11
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AKAA2515207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
AKMD2515Medicaid
150639Medicare ID - Type Unspecified
E17968Medicare UPIN