Healthcare Provider Details
I. General information
NPI: 1972855450
Provider Name (Legal Business Name): SAWRIE ONCOLOGY INC.
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 10/09/2012
Last Update Date: 10/09/2012
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
1207 AZALEA PL
BREWTON AL
36426-1337
US
IV. Provider business mailing address
1207 AZALEA PL
BREWTON AL
36426-1337
US
V. Phone/Fax
- Phone: 251-867-6544
- Fax: 251-867-6658
- Phone: 251-867-6544
- Fax: 251-867-6658
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 2085R0001X |
| Taxonomy | Radiation Oncology Physician |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
STEPHEN
SAWRIE
Title or Position: PRESIDENT
Credential: M.D.
Phone: 251-867-6544