Provider Demographics
NPI:1578963906
Name:HOGUE, SARAH E (PA)
Entity Type:Individual
Prefix:MRS
First Name:SARAH
Middle Name:E
Last Name:HOGUE
Suffix:
Gender:F
Credentials:PA
Other - Prefix:
Other - First Name:SARAH
Other - Middle Name:
Other - Last Name:CONANT
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:100 SPRADLIN FARM DR
Mailing Address - Street 2:
Mailing Address - City:CHRISTIANSBURG
Mailing Address - State:VA
Mailing Address - Zip Code:24073-1161
Mailing Address - Country:US
Mailing Address - Phone:540-381-2745
Mailing Address - Fax:
Practice Address - Street 1:100 SPRADLIN FARM DR
Practice Address - Street 2:
Practice Address - City:CHRISTIANSBURG
Practice Address - State:VA
Practice Address - Zip Code:24073-1161
Practice Address - Country:US
Practice Address - Phone:540-381-2745
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-09-04
Last Update Date:2018-03-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN99063548A363A00000X, 363AS0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AS0400XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantSurgical
No363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN000000901493OtherBCBS
INP01504490OtherRR MEDICARE
INP01504490OtherRR MEDICARE