Healthcare Provider Details

I. General information

NPI: 1164645867
Provider Name (Legal Business Name): JAMES D. SYKES D.M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/11/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3101 CAPITAL MEDICAL BLVD
TALLAHASSEE FL
32308-4411
US

IV. Provider business mailing address

3101 CAPITAL MEDICAL BLVD
TALLAHASSEE FL
32308-4411
US

V. Phone/Fax

Practice location:
  • Phone: 850-877-0536
  • Fax: 850-877-5808
Mailing address:
  • Phone: 850-877-0536
  • Fax: 850-877-5808

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223E0200X
TaxonomyEndodontics
License NumberDN0011712
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: