Provider Demographics
NPI:1124578885
Name:DEMUTH, SARAH YEAKLEY (PAC)
Entity type:Individual
Prefix:
First Name:SARAH
Middle Name:YEAKLEY
Last Name:DEMUTH
Suffix:
Gender:
Credentials:PAC
Other - Prefix:
Other - First Name:SARAH
Other - Middle Name:GIBSON
Other - Last Name:YEAKLEY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PAC
Mailing Address - Street 1:PO BOX 844658
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75284-4658
Mailing Address - Country:US
Mailing Address - Phone:254-724-8800
Mailing Address - Fax:
Practice Address - Street 1:1815 W 6TH AVE
Practice Address - Street 2:
Practice Address - City:STILLWATER
Practice Address - State:OK
Practice Address - Zip Code:74074-4202
Practice Address - Country:US
Practice Address - Phone:405-352-2098
Practice Address - Fax:405-372-4685
Is Sole Proprietor?:No
Enumeration Date:2016-10-06
Last Update Date:2025-04-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical