Healthcare Provider Details

I. General information

NPI: 1942635198
Provider Name (Legal Business Name): ERIK S SYKES
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/06/2013
Last Update Date: 09/06/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

12 SE GRAND BLVD
OKLAHOMA CITY OK
73129-2619
US

IV. Provider business mailing address

12 SE GRAND BLVD
OKLAHOMA CITY OK
73129-2619
US

V. Phone/Fax

Practice location:
  • Phone: 254-717-2383
  • Fax:
Mailing address:
  • Phone: 254-717-2383
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number StateOK

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: