Provider Demographics
NPI:1972757920
Name:GILBERT, SARA B (PAC)
Entity Type:Individual
Prefix:MRS
First Name:SARA
Middle Name:B
Last Name:GILBERT
Suffix:
Gender:F
Credentials:PAC
Other - Prefix:
Other - First Name:SARA
Other - Middle Name:MICHELLE
Other - Last Name:BUTLER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PAC
Mailing Address - Street 1:PO BOX 7648
Mailing Address - Street 2:
Mailing Address - City:PADUCAH
Mailing Address - State:KY
Mailing Address - Zip Code:42002-7648
Mailing Address - Country:US
Mailing Address - Phone:800-467-2392
Mailing Address - Fax:812-471-6650
Practice Address - Street 1:2601 KENTUCKY AVE
Practice Address - Street 2:SUITE 301
Practice Address - City:PADUCAH
Practice Address - State:KY
Practice Address - Zip Code:42003-3817
Practice Address - Country:US
Practice Address - Phone:270-575-3113
Practice Address - Fax:270-575-3135
Is Sole Proprietor?:No
Enumeration Date:2008-11-04
Last Update Date:2011-07-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KYPA1037363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant