Healthcare Provider Details

I. General information

NPI: 1366426926
Provider Name (Legal Business Name): ROBERT L SAYRE MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/06/2005
Last Update Date: 07/24/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2312 N NEVADA AVE STE 400
COLORADO SPRINGS CO
80907-5320
US

IV. Provider business mailing address

1000 RUSH DR
SALIDA CO
81201-9627
US

V. Phone/Fax

Practice location:
  • Phone: 719-577-2555
  • Fax: 719-577-2553
Mailing address:
  • Phone: 719-530-2200
  • Fax: 719-530-2201

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RH0003X
TaxonomyHematology & Oncology Physician
License Number25816
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: