Healthcare Provider Details

I. General information

NPI: 1568728863
Provider Name (Legal Business Name): MR. BRIAN WILLIAM SYKES
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/11/2012
Last Update Date: 09/11/2020
Certification Date: 09/11/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1000 N 16TH ST
NEW CASTLE IN
47362-4319
US

IV. Provider business mailing address

PO BOX 485
NEW CASTLE IN
47362-0485
US

V. Phone/Fax

Practice location:
  • Phone: 765-599-3177
  • Fax: 765-599-3176
Mailing address:
  • Phone: 765-521-1516
  • Fax: 765-599-3131

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number01076973A
License Number StateIN
# 2
Primary TaxonomyN
Taxonomy Code208M00000X
TaxonomyHospitalist Physician
License Number01076973A
License Number StateIN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: