Provider Demographics
NPI:1902941156
Name:SAWYER, JAMES DAVID (MD)
Entity Type:Individual
Prefix:
First Name:JAMES
Middle Name:DAVID
Last Name:SAWYER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 863
Mailing Address - Street 2:
Mailing Address - City:OSWEGO
Mailing Address - State:NY
Mailing Address - Zip Code:13126-0863
Mailing Address - Country:US
Mailing Address - Phone:315-349-5522
Mailing Address - Fax:315-349-5714
Practice Address - Street 1:110 W 6TH ST
Practice Address - Street 2:OSWEGO HOSPITAL
Practice Address - City:OSWEGO
Practice Address - State:NY
Practice Address - Zip Code:13126-2507
Practice Address - Country:US
Practice Address - Phone:315-349-5522
Practice Address - Fax:315-349-5714
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-21
Last Update Date:2011-11-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY198658-1207P00000X
NY198658208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
No208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY02547708Medicaid
NYJ400042168Medicare PIN
NY02547708Medicaid
NYRA 1535Medicare ID - Type Unspecified
NYJ400022340Medicare PIN