Provider Demographics
NPI:1487918843
Name:ROOS, SARAH TALLEY (OD)
Entity type:Individual
Prefix:MRS
First Name:SARAH
Middle Name:TALLEY
Last Name:ROOS
Suffix:
Gender:F
Credentials:OD
Other - Prefix:DR
Other - First Name:SARAH
Other - Middle Name:
Other - Last Name:TALLEY
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:OD
Mailing Address - Street 1:2531 W END AVE
Mailing Address - Street 2:
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37203-1423
Mailing Address - Country:US
Mailing Address - Phone:615-327-1614
Mailing Address - Fax:615-327-2413
Practice Address - Street 1:2531 W END AVE
Practice Address - Street 2:
Practice Address - City:NASHVILLE
Practice Address - State:TN
Practice Address - Zip Code:37203-1423
Practice Address - Country:US
Practice Address - Phone:615-327-1614
Practice Address - Fax:615-327-2413
Is Sole Proprietor?:Yes
Enumeration Date:2012-07-01
Last Update Date:2022-06-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN3044152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist