Provider Demographics
NPI:1447434766
Name:BARBOUR, SARAH RAY (MD)
Entity type:Individual
Prefix:DR
First Name:SARAH
Middle Name:RAY
Last Name:BARBOUR
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:555 W STATE ROAD 434
Mailing Address - Street 2:
Mailing Address - City:LONGWOOD
Mailing Address - State:FL
Mailing Address - Zip Code:32750-5119
Mailing Address - Country:US
Mailing Address - Phone:321-842-2994
Mailing Address - Fax:407-767-5801
Practice Address - Street 1:555 W STATE ROAD 434
Practice Address - Street 2:
Practice Address - City:LONGWOOD
Practice Address - State:FL
Practice Address - Zip Code:32750-5119
Practice Address - Country:US
Practice Address - Phone:321-842-2994
Practice Address - Fax:407-767-5801
Is Sole Proprietor?:No
Enumeration Date:2007-12-21
Last Update Date:2019-11-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA067274207RI0200X
FLME123838207RI0200X, 207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No207RI0200XAllopathic & Osteopathic PhysiciansInternal MedicineInfectious Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
SCGA1310Medicaid
FLME123838OtherMEDICAL LICENSE
FL014839700Medicaid
GA003122626AMedicaid
FL014839700Medicaid
GA003122626AMedicaid