# GAYLE FAYE SACRY

> Is this information incorrect? This page shows public data from NPPES. Update your record in NPPES and this page will update automatically within 7 days. [Update your NPPES record](https://nppes.cms.hhs.gov)

- **Entity:** Individual
- **Status:** Active
- **Sole proprietor:** No

## Provider details

- **NPI number:** 1821083452
- **Gender:** Man
- **Credential:** M.D.

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Q00000X | Family Medicine Physician | 3623 | MT | Yes |

## Other

- **Enumeration date:** 09/20/2005
- **Last updated:** 03/07/2023

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 0005622 | — | ID |
| 05 | — | 0068744 | — | MT |
| 01 | — | 07160 | BCBS MT PROV ID | MT |
| 01 | — | 138829 | WA WORK COMP | WA |
| 01 | — | 184739200 | FED WORK COMP GROUP ID | — |
| 01 | — | 3623 | MT LICENSE | MT |