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General NPI Number Information
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NPI Number | 1538141486
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Entity Type | Individual
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Provider Name | ANTHONY S SIKOUTRIS DPM
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Gender | Male
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Dates
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Enumeration Date | 11/16/2005
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Last Update Date | 09/30/2022
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Provider Practice Location Address
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Address Line | 519 E 13TH ST
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City | SEDALIA
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State | MO
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Zip | 65301-5909
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Country | US
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Telephone | 660-827-6311
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Fax | 660-827-5183
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Provider Business Mailing Address
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Address Line | 519 E 13TH ST
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City | SEDALIA
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State | MO
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Zip | 65301-5909
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Country | US
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Telephone | 660-827-6311
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Fax | 660-827-5183
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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 | 213ES0131X
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Taxonomy Name | Foot Surgery Podiatrist
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License Number | 000567
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License Number State | MO
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