1598713489 NPI number — STEVEN J SAWYER MD

Table of content: STEVEN J SAWYER MD (NPI 1598713489)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1598713489 NPI number — STEVEN J SAWYER MD

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
SAWYER
Provider First Name:
STEVEN
Provider Middle Name:
J
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
MD
Provider Gender Code:
M

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1598713489
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
01/06/2023
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
5880 S HOSPITAL DR
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
GLOBE
Provider Business Mailing Address State Name:
AZ
Provider Business Mailing Address Postal Code:
85501-9447
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
928-402-1131
Provider Business Mailing Address Fax Number:
928-425-3859

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
5880 S HOSPITAL DR
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
GLOBE
Provider Business Practice Location Address State Name:
AZ
Provider Business Practice Location Address Postal Code:
85501-9447
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
928-425-3247
Provider Business Practice Location Address Fax Number:
928-425-3859
Provider Enumeration Date:
05/04/2006

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 208600000X , with the licence number:  MC-1642 , registered in the state of ID ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 208600000X , with the licence number: 45647 , registered in the state of AZ ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 35252286 , issued by the state of ( CO ) . This identifiers is of the category "MEDICAID".
  • Identifier: 807611 . This is a "MEDICAIRE ID" identifier , issued by the state of ( CO ) . This identifiers is of the category "OTHER".
  • Identifier: Z208026 . This is a "MEDICARE" identifier , issued by the state of ( AZ ) . This identifiers is of the category "OTHER".
  • Identifier: 706259 , issued by the state of ( AZ ) . This identifiers is of the category "MEDICAID".




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