Sanders, Sara Shrock
Sanders, Sara Shrock is an individual health care provider with primary practice located at 2500 North State Street , Jackson MS 39216. She recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Internal Medicine, Allopathic & Osteopathic Physicians / Geriatric Medicine. Allopathic & Osteopathic Physicians / Geriatric Medicine is her primary health care specialty. Sanders, Sara Shrock can be contacted via phone (601) 984-5610.Contact Information
Primary practice address
2500 North State Street
Jackson MS 39216
Phone: (601) 984-5610
Fax: (601) 984-5783
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Internal Medicine | 207R00000X | 22084 | Mississippi |
| Allopathic & Osteopathic Physicians / Geriatric Medicine | 207RG0300X | 22084 | Mississippi |
Profile Details
| NPI number | 1477783850 |
|---|---|
| LBN Legal business name | Sanders, Sara Shrock |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jul 20th, 2009 |
| Last updated | Apr 12th, 2021 - about 4 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1477783850 | NPPES |
| Mississippi | MEDICAID | 08551340 |
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