Provider Demographics
NPI:1356722755
Name:BOMAR, SARA (MD)
Entity type:Individual
Prefix:
First Name:SARA
Middle Name:
Last Name:BOMAR
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:100 COVEY DR STE 204
Mailing Address - Street 2:
Mailing Address - City:FRANKLIN
Mailing Address - State:TN
Mailing Address - Zip Code:37067-5603
Mailing Address - Country:US
Mailing Address - Phone:615-656-0589
Mailing Address - Fax:866-250-4830
Practice Address - Street 1:100 COVEY DR STE 204
Practice Address - Street 2:
Practice Address - City:FRANKLIN
Practice Address - State:TN
Practice Address - Zip Code:37067-5603
Practice Address - Country:US
Practice Address - Phone:615-656-0589
Practice Address - Fax:866-250-4830
Is Sole Proprietor?:No
Enumeration Date:2015-06-11
Last Update Date:2019-04-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN40563208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice