Individual
SARAH PONDER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PAC
Contact information
Practice address
7777 HENNESSY BLVD STE 5000, BATON ROUGE, LA 70808-4368
(225) 765-7163
Mailing address
18509 RED OAK DR, PRAIRIEVILLE, LA 70769-3742
(225) 677-7124
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
200107
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1035068
—
LA
Enumeration date
03/20/2007
Last updated
06/11/2021
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