Provider Demographics
NPI:1790184604
Name:PADRNOS, SARAH (OD)
Entity Type:Individual
Prefix:
First Name:SARAH
Middle Name:
Last Name:PADRNOS
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1505 S YALE ST
Mailing Address - Street 2:
Mailing Address - City:FLAGSTAFF
Mailing Address - State:AZ
Mailing Address - Zip Code:86001-6330
Mailing Address - Country:US
Mailing Address - Phone:928-779-5600
Mailing Address - Fax:
Practice Address - Street 1:1505 S YALE ST
Practice Address - Street 2:
Practice Address - City:FLAGSTAFF
Practice Address - State:AZ
Practice Address - Zip Code:86001-6330
Practice Address - Country:US
Practice Address - Phone:928-779-5600
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-08-15
Last Update Date:2014-08-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ2018152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist