Provider Demographics
NPI:1316995202
Name:SAYRE, JOHN CHARLES (MD)
Entity type:Individual
Prefix:DR
First Name:JOHN
Middle Name:CHARLES
Last Name:SAYRE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:900 LESLIE ST
Mailing Address - Street 2:SUITE 1
Mailing Address - City:NASHVILLE
Mailing Address - State:AR
Mailing Address - Zip Code:71852-4017
Mailing Address - Country:US
Mailing Address - Phone:870-845-2201
Mailing Address - Fax:870-845-5031
Practice Address - Street 1:900 LESLIE ST
Practice Address - Street 2:SUITE 1
Practice Address - City:NASHVILLE
Practice Address - State:AR
Practice Address - Zip Code:71852-4017
Practice Address - Country:US
Practice Address - Phone:870-845-2201
Practice Address - Fax:870-845-5031
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-04
Last Update Date:2010-07-20
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
ARR4285208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
AR120737001Medicaid
AR120737001Medicaid
AR55083Medicare ID - Type Unspecified