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General NPI Number Information
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NPI Number | 1457582850
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Entity Type | Individual
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Provider Name | MR. MILTON SYKES JR.
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Gender | Male
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Dates
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Enumeration Date | 08/03/2009
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Last Update Date | 08/03/2009
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Provider Practice Location Address
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Address Line | 8213 CAITLIN DR
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City | OLIVE BRANCH
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State | MS
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Zip | 38654-8073
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Country | US
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Telephone | 901-581-4925
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Fax | 662-890-4499
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Provider Business Mailing Address
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Address Line | 8213 CAITLIN DR
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City | OLIVE BRANCH
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State | MS
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Zip | 38654-8073
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Country | US
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Telephone | 901-581-4925
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Fax | 662-890-4499
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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 | 172A00000X
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Taxonomy Name | Driver
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License Number | 800589962
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License Number State | MS
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