Provider Demographics
NPI:1932155785
Name:DAVIS, SARAH R (PA-C)
Entity Type:Individual
Prefix:MRS
First Name:SARAH
Middle Name:R
Last Name:DAVIS
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10101 N 92ND ST STE 101
Mailing Address - Street 2:
Mailing Address - City:SCOTTSDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85258-4553
Mailing Address - Country:US
Mailing Address - Phone:480-747-6532
Mailing Address - Fax:480-889-6865
Practice Address - Street 1:10101 N 92ND ST STE 101
Practice Address - Street 2:
Practice Address - City:SCOTTSDALE
Practice Address - State:AZ
Practice Address - Zip Code:85258-4553
Practice Address - Country:US
Practice Address - Phone:480-747-6532
Practice Address - Fax:480-889-6865
Is Sole Proprietor?:No
Enumeration Date:2006-05-25
Last Update Date:2023-05-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXPA07842363A00000X
AZ8237363AM0700X, 363A00000X
MN12503363A00000X
GA003988363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
No363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX14475002Medicaid
GA364273920AMedicaid
GA364273920EMedicaid
GA364273920CMedicaid
GA364273920DMedicaid
GA364273920FMedicaid
GA364273920AMedicaid
GA364273920CMedicaid
TXB164393Medicare PIN
GA364273920EMedicaid