Healthcare Provider Details

I. General information

NPI: 1023003266
Provider Name (Legal Business Name): MATTHEW J SYKES ANP
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/14/2005
Last Update Date: 07/11/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

300 EAST VALLEY STREET
ABINGDON VA
24210-0807
US

IV. Provider business mailing address

300 EAST VALLEY STREET
ABINGDON VA
24212-0807
US

V. Phone/Fax

Practice location:
  • Phone: 276-628-7600
  • Fax: 276-628-2629
Mailing address:
  • Phone: 276-628-5141
  • Fax: 276-628-6889

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LA2200X
TaxonomyAdult Health Nurse Practitioner
License Number24162394
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: