Provider Demographics
NPI:1306855978
Name:ASHBY, SARAH LYN (MD)
Entity type:Individual
Prefix:
First Name:SARAH
Middle Name:LYN
Last Name:ASHBY
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 1:1159 E 200 N
Mailing Address - Street 2:STE 200
Mailing Address - City:AMERICAN FORK
Mailing Address - State:UT
Mailing Address - Zip Code:84003-2022
Mailing Address - Country:US
Mailing Address - Phone:801-756-5609
Mailing Address - Fax:801-756-5200
Practice Address - Street 1:1159 E 200 N
Practice Address - Street 2:STE 200
Practice Address - City:AMERICAN FORK
Practice Address - State:UT
Practice Address - Zip Code:84003-2022
Practice Address - Country:US
Practice Address - Phone:801-756-5609
Practice Address - Fax:801-756-5200
Is Sole Proprietor?:No
Enumeration Date:2006-08-05
Last Update Date:2010-10-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA93953208000000X
UT7625419-1205208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
I50918Medicare UPIN
00A939530Medicare ID - Type UnspecifiedMCR INDIVIDUAL