Provider Demographics
NPI:1285772384
Name:HENDREN, SARA JANE HAMILTON (MD)
Entity type:Individual
Prefix:
First Name:SARA JANE
Middle Name:HAMILTON
Last Name:HENDREN
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 1:406 WISTERIA AVE
Mailing Address - Street 2:
Mailing Address - City:LOUISVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40222-4645
Mailing Address - Country:US
Mailing Address - Phone:502-749-5083
Mailing Address - Fax:
Practice Address - Street 1:406 WISTERIA AVE
Practice Address - Street 2:
Practice Address - City:LOUISVILLE
Practice Address - State:KY
Practice Address - Zip Code:40222-4645
Practice Address - Country:US
Practice Address - Phone:502-749-5083
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-02-01
Last Update Date:2008-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KYR1452207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine