Provider Demographics
NPI:1750560165
Name:SAYLE, DAVID T (MLP)
Entity type:Individual
Prefix:
First Name:DAVID
Middle Name:T
Last Name:SAYLE
Suffix:
Gender:M
Credentials:MLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:800 COVE PARKWAY
Mailing Address - Street 2:
Mailing Address - City:COTTONWOOD
Mailing Address - State:AZ
Mailing Address - Zip Code:86326
Mailing Address - Country:US
Mailing Address - Phone:928-649-3003
Mailing Address - Fax:928-649-3030
Practice Address - Street 1:800 COVE PARKWAY
Practice Address - Street 2:
Practice Address - City:COTTONWOOD
Practice Address - State:AZ
Practice Address - Zip Code:86326
Practice Address - Country:US
Practice Address - Phone:928-649-3003
Practice Address - Fax:928-649-3030
Is Sole Proprietor?:No
Enumeration Date:2007-11-01
Last Update Date:2009-07-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZRN134260363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics