Provider Demographics
NPI:1083797906
Name:SAYERS, GREGORY HANS (PA)
Entity Type:Individual
Prefix:
First Name:GREGORY
Middle Name:HANS
Last Name:SAYERS
Suffix:
Gender:M
Credentials:PA
Other - Prefix:
Other - First Name:GREGORY
Other - Middle Name:HANS
Other - Last Name:SAYERS
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:PA-C
Mailing Address - Street 1:6275 SPROULE CREEK ROAD
Mailing Address - Street 2:
Mailing Address - City:NELSON
Mailing Address - State:BRITISH COLUMBIA
Mailing Address - Zip Code:V1L6Y1
Mailing Address - Country:CA
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:110 N OAK ST
Practice Address - Street 2:
Practice Address - City:TOWNSEND
Practice Address - State:MT
Practice Address - Zip Code:59644-2306
Practice Address - Country:US
Practice Address - Phone:406-266-3189
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-23
Last Update Date:2019-05-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO2179363A00000X
AK2014363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical
No363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant