Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 208100000X | Physical Medicine & Rehabilitation Doctor | 64722 | GA |
N | 208100000X | Physical Medicine & Rehabilitation Doctor | ME102734 | FL |
N | 2081P2900X | Pain Medicine | 44283 | KY |
NPI | 1407004880 |
---|---|
Provider Name | Dr. Demosthenes N Sarlis |
First Address | Prestonsburg, KY 41653-8732 |
Second Address | Prestonsburg, KY 41653-8732 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 28/08/2008 |
Last Update Date | 23/04/2014 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
000000790378 | ANTHEM PIN (01) | KY |
003101267D | (05) | GA |
7100220230 | (05) | KY |