Provider Demographics
NPI:1568595155
Name:SAWYER, DOUGLAS C
Entity Type:Individual
Prefix:MR
First Name:DOUGLAS
Middle Name:C
Last Name:SAWYER
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9967 MORGANS TRACE DR
Mailing Address - Street 2:
Mailing Address - City:LOVELAND
Mailing Address - State:OH
Mailing Address - Zip Code:45140-8922
Mailing Address - Country:US
Mailing Address - Phone:513-793-3436
Mailing Address - Fax:
Practice Address - Street 1:12171 OMNIPLEX CT
Practice Address - Street 2:
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45240-1282
Practice Address - Country:US
Practice Address - Phone:513-671-7240
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-13
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH03208411183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist