Provider Demographics
NPI:1730166968
Name:SAILORS, SANDRA J (MD)
Entity type:Individual
Prefix:
First Name:SANDRA
Middle Name:J
Last Name:SAILORS
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:SANDRA
Other - Middle Name:J
Other - Last Name:HALLER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:P.O. BOX 632317
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45263-2317
Mailing Address - Country:US
Mailing Address - Phone:937-208-7288
Mailing Address - Fax:937-208-7290
Practice Address - Street 1:1 WYOMING ST.
Practice Address - Street 2:3 FL / ANESTHESIA DEPT
Practice Address - City:DAYTON
Practice Address - State:OH
Practice Address - Zip Code:45409
Practice Address - Country:US
Practice Address - Phone:937-208-4380
Practice Address - Fax:937-208-3843
Is Sole Proprietor?:No
Enumeration Date:2005-12-29
Last Update Date:2011-04-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35068980207L00000X
OH35.072370207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0290037Medicaid
OHHA0793252Medicare UPIN
OH0290037Medicaid