Provider Demographics
NPI:1942462965
Name:PYATT, SARA M (OD)
Entity Type:Individual
Prefix:DR
First Name:SARA
Middle Name:M
Last Name:PYATT
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:PO BOX 64
Mailing Address - Street 2:
Mailing Address - City:POTOSI
Mailing Address - State:MO
Mailing Address - Zip Code:63664-0064
Mailing Address - Country:US
Mailing Address - Phone:314-607-3260
Mailing Address - Fax:
Practice Address - Street 1:307 N MISSOURI ST
Practice Address - Street 2:
Practice Address - City:POTOSI
Practice Address - State:MO
Practice Address - Zip Code:63664-1747
Practice Address - Country:US
Practice Address - Phone:573-438-3415
Practice Address - Fax:573-438-7667
Is Sole Proprietor?:No
Enumeration Date:2008-06-30
Last Update Date:2012-10-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2008017062152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist