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General NPI Number Information
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NPI Number | 1013356641
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Entity Type | Organization
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Legal Business Name | REGINALD L. SYKES, SR, M.D., P.A.
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Dates
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Enumeration Date | 06/17/2013
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Last Update Date | 06/17/2013
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Provider Practice Location Address
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Address Line | 3160 EDGEWOOD AVE W
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City | JACKSONVILLE
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State | FL
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Zip | 32209-2245
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Country | US
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Telephone | 904-768-8222
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Fax | 904-482-0373
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Provider Business Mailing Address
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Address Line | 3160 EDGEWOOD AVE W
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City | JACKSONVILLE
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State | FL
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Zip | 32209-2245
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Country | US
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Telephone | 904-768-8222
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Fax | 904-482-0373
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Authorized Official
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Title or Position | PRESIDENT/PHYSICIAN
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Name | DR. REGINALD L SYKES SR.
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Credential | M.D.
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Telephone | 904-768-8222
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | ME58350
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License Number State | FL
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