Provider Demographics
NPI:1942771183
Name:SLOOP, SARAH ELIZABETH (PA-C)
Entity Type:Individual
Prefix:
First Name:SARAH
Middle Name:ELIZABETH
Last Name:SLOOP
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4300 W MAIN ST STE 24
Mailing Address - Street 2:
Mailing Address - City:DOTHAN
Mailing Address - State:AL
Mailing Address - Zip Code:36305-1312
Mailing Address - Country:US
Mailing Address - Phone:334-944-4104
Mailing Address - Fax:334-944-4215
Practice Address - Street 1:4300 W MAIN ST STE 24
Practice Address - Street 2:
Practice Address - City:DOTHAN
Practice Address - State:AL
Practice Address - Zip Code:36305-1312
Practice Address - Country:US
Practice Address - Phone:334-944-4104
Practice Address - Fax:334-944-4215
Is Sole Proprietor?:No
Enumeration Date:2018-12-16
Last Update Date:2018-12-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ALPA.1419363AS0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AS0400XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantSurgical