Provider Demographics
NPI:1760441984
Name:CALAHAN, SARA GAGE (PAC)
Entity Type:Individual
Prefix:MRS
First Name:SARA
Middle Name:GAGE
Last Name:CALAHAN
Suffix:
Gender:F
Credentials:PAC
Other - Prefix:MS
Other - First Name:SARA
Other - Middle Name:ANNE
Other - Last Name:GAGE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PAC
Mailing Address - Street 1:PO BOX 727
Mailing Address - Street 2:
Mailing Address - City:DECATUR
Mailing Address - State:AL
Mailing Address - Zip Code:35602-0727
Mailing Address - Country:US
Mailing Address - Phone:256-584-0056
Mailing Address - Fax:
Practice Address - Street 1:1215 7TH ST SE
Practice Address - Street 2:SUITE 130
Practice Address - City:DECATUR
Practice Address - State:AL
Practice Address - Zip Code:35601-3337
Practice Address - Country:US
Practice Address - Phone:256-584-0056
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-03-18
Last Update Date:2009-10-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ALPA390363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL0910134OtherUNITED HEALTHCARE
AL009978275Medicaid
AL51049722OtherBCBS
AL51049723OtherBCBS
AL051555199OtherMEDICARE
AL51049723OtherBCBS