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Individual

DENNIS R SAWYER

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
P.A.-C

Contact information

Practice address
775 POLE LINE RD W, SUITE 112, TWIN FALLS, ID 83301-5814
(208) 814-8200
(208) 933-4921
Mailing address
PO BOX 587, TWIN FALLS, ID 83303-0587
(208) 814-7400
(208) 814-7491

Taxonomy

Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA471
ID

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
806765700
ID
01
P00390642
RR MEDICARE
ID
Enumeration date
07/06/2006
Last updated
09/06/2012
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