Provider Demographics
NPI:1275041824
Name:RANDOLPH B. SAWYER
Entity Type:Organization
Organization Name:RANDOLPH B. SAWYER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:RANDOLPH
Authorized Official - Middle Name:B
Authorized Official - Last Name:SAWYER
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:207-753-0800
Mailing Address - Street 1:100 MOUNT AUBURN AVE
Mailing Address - Street 2:
Mailing Address - City:AUBURN
Mailing Address - State:ME
Mailing Address - Zip Code:04210-8651
Mailing Address - Country:US
Mailing Address - Phone:207-310-0281
Mailing Address - Fax:207-221-1793
Practice Address - Street 1:100 MOUNT AUBURN AVE
Practice Address - Street 2:
Practice Address - City:AUBURN
Practice Address - State:ME
Practice Address - Zip Code:04210-8651
Practice Address - Country:US
Practice Address - Phone:207-310-0281
Practice Address - Fax:207-221-1793
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-01-17
Last Update Date:2018-01-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty