Provider Demographics
NPI:1295932366
Name:BOZEMAN, SARAH A (DO)
Entity type:Individual
Prefix:DR
First Name:SARAH
Middle Name:A
Last Name:BOZEMAN
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:9800 SHELBYVILLE RD
Mailing Address - Street 2:SUITE #220
Mailing Address - City:LOUISVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40223-2992
Mailing Address - Country:US
Mailing Address - Phone:502-429-8585
Mailing Address - Fax:855-656-7325
Practice Address - Street 1:971 SOUTH HIGHWAY 27
Practice Address - Street 2:
Practice Address - City:SOMERSET
Practice Address - State:KY
Practice Address - Zip Code:42003
Practice Address - Country:US
Practice Address - Phone:606-451-0239
Practice Address - Fax:855-656-7325
Is Sole Proprietor?:No
Enumeration Date:2007-06-30
Last Update Date:2021-03-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY03375207K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207K00000XAllopathic & Osteopathic PhysiciansAllergy & Immunology
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY50034391OtherPASSPORT
KY7100172180Medicaid
000000726124OtherANTHEM
KYP01049647OtherMEDICARE RAILROAD
KY50034391OtherPASSPORT