Provider Demographics
NPI:1154433712
Name:FOUKE, SARAH JOST (MD)
Entity type:Individual
Prefix:DR
First Name:SARAH
Middle Name:JOST
Last Name:FOUKE
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:SARAH
Other - Middle Name:CHRISTINE
Other - Last Name:JOST
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:12855 N 40 DR STE 375
Mailing Address - Street 2:
Mailing Address - City:SAINT LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63141-8657
Mailing Address - Country:US
Mailing Address - Phone:314-806-1770
Mailing Address - Fax:314-558-9017
Practice Address - Street 1:3 SAINT ELIZABETH BLVD STE 3900
Practice Address - Street 2:
Practice Address - City:O FALLON
Practice Address - State:IL
Practice Address - Zip Code:62269-1282
Practice Address - Country:US
Practice Address - Phone:888-828-8608
Practice Address - Fax:314-558-9017
Is Sole Proprietor?:No
Enumeration Date:2006-08-31
Last Update Date:2024-01-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2015017231207T00000X
IL036157579207T00000X, 207T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207T00000XAllopathic & Osteopathic PhysiciansNeurological Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO113620051OtherMEDICARE MO
MO200063204Medicaid
ILF400775751OtherMEDICARE IL
P00398650Medicare PIN
WAG8881562Medicare UPIN
I63658Medicare UPIN