Basic Information
| Provider Information | |||||||||
| NPI: | 1770041477 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | HAGERBRANT | ||||||||
| FirstName: | SARAH | ||||||||
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| Credential: | DO | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 746638 | ||||||||
| Address2: | |||||||||
| City: | ATLANTA | ||||||||
| State: | GA | ||||||||
| PostalCode: | 303746638 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7402494122 | ||||||||
| FaxNumber: | 7402494126 | ||||||||
| Practice Location | |||||||||
| Address1: | 30 ARDISIA LANE | ||||||||
| Address2: | |||||||||
| City: | ST. JOHNS | ||||||||
| State: | FL | ||||||||
| PostalCode: | 32259 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9042872794 | ||||||||
| FaxNumber: | 9043907458 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 03/12/2019 | ||||||||
| LastUpdateDate: | 09/09/2022 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 09/08/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207Q00000X | OS19161 | FL | Y | Allopathic & Osteopathic Physicians | Family Medicine |
No ID Information.