Provider Demographics
NPI:1699968321
Name:WILLIAR, SARA BERTHA (MD)
Entity type:Individual
Prefix:DR
First Name:SARA
Middle Name:BERTHA
Last Name:WILLIAR
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 1:710 COOPER RD
Mailing Address - Street 2:
Mailing Address - City:STRAWBERRY PLAINS
Mailing Address - State:TN
Mailing Address - Zip Code:37871-1464
Mailing Address - Country:US
Mailing Address - Phone:865-933-1972
Mailing Address - Fax:865-933-9682
Practice Address - Street 1:710 COOPER RD
Practice Address - Street 2:
Practice Address - City:STRAWBERRY PLAINS
Practice Address - State:TN
Practice Address - Zip Code:37871-1464
Practice Address - Country:US
Practice Address - Phone:865-933-1972
Practice Address - Fax:865-933-9682
Is Sole Proprietor?:Yes
Enumeration Date:2007-08-27
Last Update Date:2007-08-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNMD169892084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN3024423Medicaid
TNA98886Medicare UPIN