Provider Demographics
NPI:1427066406
Name:SAWYER, JAMES HOBART (OD)
Entity type:Individual
Prefix:
First Name:JAMES
Middle Name:HOBART
Last Name:SAWYER
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:150 N MAIN ST
Mailing Address - Street 2:
Mailing Address - City:MONTICELLO
Mailing Address - State:KY
Mailing Address - Zip Code:42633-1438
Mailing Address - Country:US
Mailing Address - Phone:606-348-9392
Mailing Address - Fax:606-348-4942
Practice Address - Street 1:150 N MAIN ST
Practice Address - Street 2:
Practice Address - City:MONTICELLO
Practice Address - State:KY
Practice Address - Zip Code:42633-1438
Practice Address - Country:US
Practice Address - Phone:606-348-9392
Practice Address - Fax:606-348-4942
Is Sole Proprietor?:No
Enumeration Date:2006-08-04
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY1083DT152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY77010833Medicaid
MS0213087OtherDEA
0721401Medicare ID - Type Unspecified
MS0213087OtherDEA