Basic Information
Provider Information
NPI: 1144623315
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: MCMULLEN
FirstName: SARAH
MiddleName: A
NamePrefix:  
NameSuffix:  
Credential: M.D.
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName: CLIFTON
OtherFirstName: SARAH
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType: 1
Mailing Information
Address1: PO BOX 236
Address2:  
City: BATESVILLE
State: IN
PostalCode: 470060236
CountryCode: US
TelephoneNumber: 8129323371
FaxNumber: 8129323506
Practice Location
Address1: 188 STATE ROAD 129 S
Address2:  
City: BATESVILLE
State: IN
PostalCode: 470067628
CountryCode: US
TelephoneNumber: 8129346400
FaxNumber: 8129346330
Other Information
ProviderEnumerationDate: 10/02/2014
LastUpdateDate: 03/29/2021
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 03/29/2021

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207Q00000X01078813AINY Allopathic & Osteopathic PhysiciansFamily Medicine 

No ID Information.


Home