Provider Demographics
NPI:1912934977
Name:LEE-DAVISSON, SARAH J (MD)
Entity type:Individual
Prefix:DR
First Name:SARAH
Middle Name:J
Last Name:LEE-DAVISSON
Suffix:
Gender:
Credentials:MD
Other - Prefix:
Other - First Name:SARAH
Other - Middle Name:J
Other - Last Name:LEE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:11817 N MOUNTAIN LAUREL PL
Mailing Address - Street 2:
Mailing Address - City:ORO VALLEY
Mailing Address - State:AZ
Mailing Address - Zip Code:85737-7825
Mailing Address - Country:US
Mailing Address - Phone:520-237-4712
Mailing Address - Fax:
Practice Address - Street 1:5301 E GRANT RD
Practice Address - Street 2:
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85712-2874
Practice Address - Country:US
Practice Address - Phone:520-324-6048
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-27
Last Update Date:2025-03-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ36552208600000X, 208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ221618Medicaid
I69605Medicare UPIN
AZZ121329Medicare PIN