Provider Demographics
NPI:1396733457
Name:FELT, SARAH B (DO)
Entity type:Individual
Prefix:
First Name:SARAH
Middle Name:B
Last Name:FELT
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
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Mailing Address - Street 1:916 INDIANA AVE
Mailing Address - Street 2:SUITE 120
Mailing Address - City:PUEBLO
Mailing Address - State:CO
Mailing Address - Zip Code:81004-3572
Mailing Address - Country:US
Mailing Address - Phone:719-562-1122
Mailing Address - Fax:719-562-0244
Practice Address - Street 1:916 INDIANA AVE
Practice Address - Street 2:SUITE 120
Practice Address - City:PUEBLO
Practice Address - State:CO
Practice Address - Zip Code:81004-3572
Practice Address - Country:US
Practice Address - Phone:719-562-1122
Practice Address - Fax:719-562-0244
Is Sole Proprietor?:No
Enumeration Date:2005-10-12
Last Update Date:2008-05-05
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Provider Licenses
StateLicense IDTaxonomies
CO39953207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO45850224Medicaid
CO840706945OtherROCKY MOUNTAIN HEATLH PLA
P00231963OtherTRAVELERS MEDICARE
COFE668556OtherANTHEM BCBS
14688778OtherNEW MEXICO MEDICAID
14688778OtherNEW MEXICO MEDICAID
P00231963OtherTRAVELERS MEDICARE