Healthcare Provider Details

I. General information

NPI: 1831268655
Provider Name (Legal Business Name): JAMES R SAWYER MD PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/07/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2425 W 21ST
CLOVIS NM
88101
US

IV. Provider business mailing address

PO BOX 5586
CLOVIS NM
88102-5586
US

V. Phone/Fax

Practice location:
  • Phone: 505-763-9800
  • Fax: 505-769-1998
Mailing address:
  • Phone: 505-763-9800
  • Fax: 505-769-1998

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number95-140
License Number StateNM

VIII. Authorized Official

Name: DR. JAMES R SAWYER
Title or Position: OWNER
Credential: M.D.
Phone: 505-763-9800