Provider Demographics
NPI:1881613131
Name:CAREY, SARAH M (PA)
Entity type:Individual
Prefix:
First Name:SARAH
Middle Name:M
Last Name:CAREY
Suffix:
Gender:F
Credentials:PA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1500 OGLETHORPE AVE
Mailing Address - Street 2:BLDG 600 STE EF
Mailing Address - City:ATHENS
Mailing Address - State:GA
Mailing Address - Zip Code:30606-2179
Mailing Address - Country:US
Mailing Address - Phone:706-613-6080
Mailing Address - Fax:706-613-6562
Practice Address - Street 1:1500 OGLETHORPE AVE
Practice Address - Street 2:BLDG 600 STE EF
Practice Address - City:ATHENS
Practice Address - State:GA
Practice Address - Zip Code:30606-2179
Practice Address - Country:US
Practice Address - Phone:706-613-6080
Practice Address - Fax:706-613-6562
Is Sole Proprietor?:No
Enumeration Date:2006-07-18
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA003910363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA97WCDGXMedicare ID - Type Unspecified
GAP82056Medicare UPIN