Basic Information
Provider Information
NPI: 1992885669
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: FILSON
FirstName: SARAH
MiddleName: KERLIN
NamePrefix:  
NameSuffix:  
Credential: MD
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 11109 PARKVIEW PLAZA DR # 117
Address2:  
City: FORT WAYNE
State: IN
PostalCode: 468451701
CountryCode: US
TelephoneNumber:  
FaxNumber:  
Practice Location
Address1: 11123 PARKVIEW PLAZA DR STE 101
Address2:  
City: FORT WAYNE
State: IN
PostalCode: 468451707
CountryCode: US
TelephoneNumber: 2604256650
FaxNumber: 2604256649
Other Information
ProviderEnumerationDate: 10/17/2006
LastUpdateDate: 10/15/2022
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 10/15/2022

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207V00000X01059500AINY Allopathic & Osteopathic PhysiciansObstetrics & Gynecology 

ID Information
IDTypeStateIssuerDescription
00000052563901INANTHEMOTHER
P0129158501INRAILROAD MEDICAREOTHER
20084631005IN MEDICAID


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