Provider Demographics
NPI:1558772335
Name:CLARK, SARA EMILY ALLEN (MD)
Entity type:Individual
Prefix:DR
First Name:SARA
Middle Name:EMILY ALLEN
Last Name:CLARK
Suffix:
Gender:F
Credentials:MD
Other - Prefix:MS
Other - First Name:SARA
Other - Middle Name:EMILY
Other - Last Name:ALLEN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:3300 CAHABA RD STE 102
Mailing Address - Street 2:
Mailing Address - City:BIRMINGHAM
Mailing Address - State:AL
Mailing Address - Zip Code:35223-2629
Mailing Address - Country:US
Mailing Address - Phone:205-874-3566
Mailing Address - Fax:205-638-9996
Practice Address - Street 1:3300 CAHABA RD STE 102
Practice Address - Street 2:
Practice Address - City:BIRMINGHAM
Practice Address - State:AL
Practice Address - Zip Code:35223-2629
Practice Address - Country:US
Practice Address - Phone:205-870-7292
Practice Address - Fax:205-638-9996
Is Sole Proprietor?:No
Enumeration Date:2014-05-14
Last Update Date:2025-04-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MST-2782208000000X
MS25122208000000X, 208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics