MEDICARE: HENRY ARCHER SAKOW MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	2084P0800X	Psychiatry Physician	023870	GA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1114904042
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	HENRY ARCHER SAKOW MD

Provider Business Mailing Address
First Line	:	PO BOX 1828
Second Line	:
City	:	ALBANY
State	:	GA
Zip	:	31702-1828
Country	:	US
Telephone Number	:	229-312-7000
Fax Number	:	229-312-7006

Provider Business Practice Location Address
First Line	:	500 W 3RD AVE
Second Line	:	SUITE 105
City	:	ALBANY
State	:	GA
Zip	:	31701-1985
Country	:	US
Telephone Number	:	229-312-7000
Fax Number	:	229-312-7006

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/30/2005
Last Update Date	:	02/21/2012

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