Basic Information
| Provider Information | |||||||||
| NPI: | 1730382334 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | BEHRENS | ||||||||
| FirstName: | SARA | ||||||||
| MiddleName: | STREBE | ||||||||
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| Credential: | MD | ||||||||
| OtherOrganizationName: | |||||||||
| OtherOrganizationType: | |||||||||
| OtherLastName: | STREBE | ||||||||
| OtherFirstName: | SARA | ||||||||
| OtherMiddleName: | ELISABETH | ||||||||
| OtherNamePrefix: | |||||||||
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| OtherCredential: | MD | ||||||||
| OtherLastNameType: | 1 | ||||||||
| Mailing Information | |||||||||
| Address1: | 840 PINE ST | ||||||||
| Address2: | STE 500 | ||||||||
| City: | MACON | ||||||||
| State: | GA | ||||||||
| PostalCode: | 312012100 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4786338682 | ||||||||
| FaxNumber: | 4786338698 | ||||||||
| Practice Location | |||||||||
| Address1: | 840 PINE ST | ||||||||
| Address2: | STE 500 | ||||||||
| City: | MACON | ||||||||
| State: | GA | ||||||||
| PostalCode: | 312012100 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4786338682 | ||||||||
| FaxNumber: | 4786338698 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 06/09/2007 | ||||||||
| LastUpdateDate: | 09/08/2020 | ||||||||
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| ProviderGenderCode: | F | ||||||||
| AuthorizedOfficialLastName: | |||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 09/08/2020 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207XX0801X | 077086 | GA | Y | Allopathic & Osteopathic Physicians | Orthopaedic Surgery | Orthopaedic Trauma |
No ID Information.