MEDICARE: MR. GARY SAYLOR CRNA

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	367500000X	Certified Registered Nurse Anesthetist	31251	VA

General Provider Information

NPI Number	:	1528137981
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. GARY SAYLOR CRNA

Provider Business Mailing Address
First Line	:	999 EXECUTIVE PARK BLVD
Second Line	:	SUITE 201
City	:	KINGSPORT
State	:	TN
Zip	:	37660-4632
Country	:	US
Telephone Number	:	423-224-3250
Fax Number	:	423-224-3258

Provider Business Practice Location Address
First Line	:	127 HEALTH CARE DR
Second Line	:
City	:	PENNINGTON GAP
State	:	VA
Zip	:	24277-2853
Country	:	US
Telephone Number	:	276-546-1440
Fax Number	:	276-546-5759

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

Provider Enumeration Date	:	11/07/2006
Last Update Date	:	05/07/2010

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