Provider Demographics
NPI:1366579310
Name:HOVANEC, SARA L
Entity type:Individual
Prefix:
First Name:SARA
Middle Name:L
Last Name:HOVANEC
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:695 S ALTON WAY
Mailing Address - Street 2:4D
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80247-1701
Mailing Address - Country:US
Mailing Address - Phone:303-364-4833
Mailing Address - Fax:
Practice Address - Street 1:2550 S PARKER RD STE 400
Practice Address - Street 2:
Practice Address - City:AURORA
Practice Address - State:CO
Practice Address - Zip Code:80014-1677
Practice Address - Country:US
Practice Address - Phone:303-636-3350
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-02-27
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO49223208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
012534OtherKAISER-COMMERCIAL NUMBER