Healthcare Provider Details

I. General information

NPI: 1285607713
Provider Name (Legal Business Name): ALLAN THOMAS SAWYER M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/07/2006
Last Update Date: 08/31/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8211 W WILLIAMS RD
PEORIA AZ
85383-1617
US

IV. Provider business mailing address

PO BOX 11660
GLENDALE AZ
85318-1660
US

V. Phone/Fax

Practice location:
  • Phone: 602-319-0950
  • Fax: 623-594-6322
Mailing address:
  • Phone: 602-509-2888
  • Fax: 623-594-6322

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License Number19793
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: