Provider Demographics
NPI:1114915154
Name:SAWYER, MICHAEL P (CRNA)
Entity Type:Individual
Prefix:MR
First Name:MICHAEL
Middle Name:P
Last Name:SAWYER
Suffix:
Gender:M
Credentials:CRNA
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 22390
Mailing Address - Street 2:
Mailing Address - City:HOT SPRINGS
Mailing Address - State:AR
Mailing Address - Zip Code:71903-2390
Mailing Address - Country:US
Mailing Address - Phone:800-235-1415
Mailing Address - Fax:913-234-1108
Practice Address - Street 1:1636 HIGDON FERRY RD
Practice Address - Street 2:MLK BOULEVARD
Practice Address - City:HOT SPRINGS
Practice Address - State:AR
Practice Address - Zip Code:71913-6912
Practice Address - Country:US
Practice Address - Phone:501-520-5215
Practice Address - Fax:501-520-3704
Is Sole Proprietor?:No
Enumeration Date:2005-10-13
Last Update Date:2008-03-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARC00334367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered
Provider Identifiers
StateIdentifier IDID TypeIssuer
AR59812OtherBCBS
P00276006OtherRR MEDICARE GROUP CK 6327
AR59812OtherBCBS
AR59812Medicare ID - Type Unspecified
AR59812Medicare PIN