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General NPI Number Information
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NPI Number | 1396125829
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Entity Type | Individual
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Provider Name | WHITNEY RAYANNE SYRUS D.P.M.
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Gender | Female
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Dates
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Enumeration Date | 05/29/2015
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Last Update Date | 08/27/2021
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Provider Practice Location Address
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Address Line | 141 SCOUTING CIR
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City | TROY
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State | AL
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Zip | 36081-2540
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Country | US
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Telephone | 334-494-8200
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Fax | 334-460-1984
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Provider Business Mailing Address
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Address Line | 107 E WATTS ST
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City | ENTERPRISE
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State | AL
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Zip | 36330-2511
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Country | US
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Telephone | 334-494-8200
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Fax | 334-460-1984
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 213ES0103X
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Taxonomy Name | Foot & Ankle Surgery Podiatrist
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License Number | 345
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License Number State | AL
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