Provider Demographics
NPI:1639561822
Name:ZATCHOK, SARA JESSICA (PA-C)
Entity type:Individual
Prefix:
First Name:SARA
Middle Name:JESSICA
Last Name:ZATCHOK
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:SARA
Other - Middle Name:JESSICA
Other - Last Name:WALKER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PA-C
Mailing Address - Street 1:835 MCKAY CT STE 100
Mailing Address - Street 2:
Mailing Address - City:BOARDMAN
Mailing Address - State:OH
Mailing Address - Zip Code:44512-5786
Mailing Address - Country:US
Mailing Address - Phone:330-758-4399
Mailing Address - Fax:330-758-8995
Practice Address - Street 1:835 MCKAY CT STE 100
Practice Address - Street 2:
Practice Address - City:BOARDMAN
Practice Address - State:OH
Practice Address - Zip Code:44512-5786
Practice Address - Country:US
Practice Address - Phone:330-758-4399
Practice Address - Fax:330-758-8995
Is Sole Proprietor?:No
Enumeration Date:2015-02-24
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH50.004291RX363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0126579Medicaid
OHH281050Medicare PIN