Provider Demographics
NPI:1619993466
Name:HART, SARAH RENEE (MD)
Entity Type:Individual
Prefix:
First Name:SARAH
Middle Name:RENEE
Last Name:HART
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 1:1707 CEDAR GROVE RD
Mailing Address - Street 2:20
Mailing Address - City:SHEPHERDSVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40165-8572
Mailing Address - Country:US
Mailing Address - Phone:502-215-5090
Mailing Address - Fax:
Practice Address - Street 1:1707 CEDAR GROVE RD
Practice Address - Street 2:20
Practice Address - City:SHEPHERDSVILLE
Practice Address - State:KY
Practice Address - Zip Code:40165-8572
Practice Address - Country:US
Practice Address - Phone:502-215-5090
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-14
Last Update Date:2011-01-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY39947208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics