Provider Demographics
NPI:1588897532
Name:LAIN, SARAH GLORIA (MD)
Entity type:Individual
Prefix:DR
First Name:SARAH
Middle Name:GLORIA
Last Name:LAIN
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 1:7240 WESTHAVEN RD
Mailing Address - Street 2:
Mailing Address - City:NEW ORLEANS
Mailing Address - State:LA
Mailing Address - Zip Code:70126-2135
Mailing Address - Country:US
Mailing Address - Phone:504-241-8894
Mailing Address - Fax:
Practice Address - Street 1:7240 WESTHAVEN RD
Practice Address - Street 2:
Practice Address - City:NEW ORLEANS
Practice Address - State:LA
Practice Address - Zip Code:70126-2135
Practice Address - Country:US
Practice Address - Phone:504-241-8894
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-08-25
Last Update Date:2024-06-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LAMD.013051208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA301795Medicaid