Provider Demographics
NPI:1801113568
Name:JAGER, SARA A (MD)
Entity type:Individual
Prefix:DR
First Name:SARA
Middle Name:A
Last Name:JAGER
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:SARA
Other - Middle Name:A
Other - Last Name:KIERPIEC
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:PO BOX 600
Mailing Address - Street 2:ATTN: MED STAFF OFFICE
Mailing Address - City:TUBA CITY
Mailing Address - State:AZ
Mailing Address - Zip Code:86045-0600
Mailing Address - Country:US
Mailing Address - Phone:808-554-9385
Mailing Address - Fax:928-283-2761
Practice Address - Street 1:167 N MAIN STREET
Practice Address - Street 2:ATTN: MED STAFF OFFICE
Practice Address - City:TUBA CITY
Practice Address - State:AZ
Practice Address - Zip Code:86045-0600
Practice Address - Country:US
Practice Address - Phone:808-554-9385
Practice Address - Fax:928-283-2761
Is Sole Proprietor?:Yes
Enumeration Date:2010-04-21
Last Update Date:2013-08-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT81534841205208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics