Provider Demographics
NPI:1760478275
Name:SAYRE, WILLIAM JAMES SR (MD)
Entity type:Individual
Prefix:
First Name:WILLIAM
Middle Name:JAMES
Last Name:SAYRE
Suffix:SR
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:108 HOUSTON ST
Mailing Address - Street 2:
Mailing Address - City:LEXINGTON
Mailing Address - State:VA
Mailing Address - Zip Code:24450-2455
Mailing Address - Country:US
Mailing Address - Phone:540-463-2181
Mailing Address - Fax:540-463-1125
Practice Address - Street 1:108 HOUSTON ST
Practice Address - Street 2:
Practice Address - City:LEXINGTON
Practice Address - State:VA
Practice Address - Zip Code:24450-2455
Practice Address - Country:US
Practice Address - Phone:540-463-2181
Practice Address - Fax:540-463-1125
Is Sole Proprietor?:No
Enumeration Date:2005-09-21
Last Update Date:2020-12-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101229127207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA010206766Medicaid
VA110215754OtherRAILROAD MEDICARE
VA144808OtherSOUTHREN HEALTH SERVICES
VA140212OtherANTHEM
VA005824931Medicaid
VA144808OtherSOUTHREN HEALTH SERVICES
VA110215754OtherRAILROAD MEDICARE
VA010206766Medicaid
VA110007910Medicare PIN
VA009070S57Medicare PIN