Provider Demographics
NPI:1275224693
Name:SAYRE FAMILY MEDICINE CLINIC PLLC
Entity Type:Organization
Organization Name:SAYRE FAMILY MEDICINE CLINIC PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:SONJA
Authorized Official - Middle Name:
Authorized Official - Last Name:LANGLEY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:580-210-2024
Mailing Address - Street 1:1002 NE HIGHWAY 66 STE 3
Mailing Address - Street 2:
Mailing Address - City:SAYRE
Mailing Address - State:OK
Mailing Address - Zip Code:73662-9312
Mailing Address - Country:US
Mailing Address - Phone:580-210-1565
Mailing Address - Fax:580-200-3035
Practice Address - Street 1:1002 NE HIGHWAY 66 STE 3
Practice Address - Street 2:
Practice Address - City:SAYRE
Practice Address - State:OK
Practice Address - Zip Code:73662-9312
Practice Address - Country:US
Practice Address - Phone:580-210-1565
Practice Address - Fax:580-003-0352
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:5 STAR HEALTH, PLLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2023-05-17
Last Update Date:2024-04-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OK1083339154OtherNPI
OK1174730881OtherNPI