Provider Demographics
NPI:1881663748
Name:SPEESE, SARAH (MD)
Entity Type:Individual
Prefix:DR
First Name:SARAH
Middle Name:
Last Name:SPEESE
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1303 DANTIGNAC ST
Mailing Address - Street 2:SUITE 2500
Mailing Address - City:AUGUSTA
Mailing Address - State:GA
Mailing Address - Zip Code:30901-2775
Mailing Address - Country:US
Mailing Address - Phone:706-733-4427
Mailing Address - Fax:706-737-0215
Practice Address - Street 1:1303 DANTIGNAC ST
Practice Address - Street 2:SUITE 2500
Practice Address - City:AUGUSTA
Practice Address - State:GA
Practice Address - Zip Code:30901-2775
Practice Address - Country:US
Practice Address - Phone:706-733-4427
Practice Address - Fax:706-737-0215
Is Sole Proprietor?:No
Enumeration Date:2006-03-14
Last Update Date:2013-04-09
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
GA032995207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA338169OtherWELLCARE
GA10057975OtherAMERIGROUP
GA160320113AMedicaid
GA160012471OtherRAILROAD MEDICARE
GA160320113AMedicaid
GAE99790Medicare UPIN