Provider Demographics
NPI:1013950765
Name:SAYOUR, PAUL E (DC)
Entity Type:Individual
Prefix:DR
First Name:PAUL
Middle Name:E
Last Name:SAYOUR
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:85 SACHEM ST
Mailing Address - Street 2:
Mailing Address - City:NORWICH
Mailing Address - State:CT
Mailing Address - Zip Code:06360
Mailing Address - Country:US
Mailing Address - Phone:860-889-5812
Mailing Address - Fax:860-886-9247
Practice Address - Street 1:85 SACHEM ST
Practice Address - Street 2:
Practice Address - City:NORWICH
Practice Address - State:CT
Practice Address - Zip Code:06360
Practice Address - Country:US
Practice Address - Phone:860-889-5812
Practice Address - Fax:860-886-9247
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-13
Last Update Date:2011-05-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RIDCP00345111N00000X
CT000815111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
CT00417302700Medicaid
RI709003399OtherPTAN
CT050000815CT01OtherBCBS
RI709003399Medicaid
RI709003399OtherPTAN
RI709003399Medicaid
CT00417302700Medicaid