MEDICARE: JOE W SAYRE 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	208600000X	Surgery Physician	35050180S	OH

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
2	00331	OTHER		PARAMOUNT
3	000000576671	OTHER		ANTHEM
4	04062385	OTHER		AETNA
5	P00667926	OTHER	OH	RRMC

General Provider Information

NPI Number	:	1396742078
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JOE W SAYRE MD

Provider Business Mailing Address
First Line	:	1250 RALSTON AVE
Second Line	:	SUITE 203
City	:	DEFIANCE
State	:	OH
Zip	:	43512-5311
Country	:	US
Telephone Number	:	419-783-6997
Fax Number	:	419-782-6873

Provider Business Practice Location Address
First Line	:	1250 RALSTON AVE
Second Line	:	SUITE 203
City	:	DEFIANCE
State	:	OH
Zip	:	43512-5311
Country	:	US
Telephone Number	:	419-783-6997
Fax Number	:	419-782-6873

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

Provider Enumeration Date	:	07/07/2005
Last Update Date	:	03/11/2009

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Directions to “ JOE W SAYRE MD” Practice Location

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