Individual
SARAH THAYER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
1023 NEW MOODY LN, SUITE 201, LA GRANGE, KY 40031-9177
(502) 225-5520
(502) 225-5522
Mailing address
PO BOX 950248, LOUISVILLE, KY 40295-0248
(502) 253-4900
(502) 489-5750
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
48855
KY
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
7100249960
—
KY
01
—
K200970
MEDICARE PTAN
KY
Enumeration date
03/19/2012
Last updated
08/11/2016
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