Basic Information
Provider Information
NPI: 1760831028
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: SYKES
FirstName: WILLIAM
MiddleName: M
NamePrefix: DR.
NameSuffix:  
Credential: DO
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 4715 WHITESBURG DR SE
Address2:  
City: HUNTSVILLE
State: AL
PostalCode: 358021632
CountryCode: US
TelephoneNumber: 2568815151
FaxNumber: 9102727153
Practice Location
Address1: 4715 WHITESBURG DR SE
Address2:  
City: HUNTSVILLE
State: AL
PostalCode: 358021632
CountryCode: US
TelephoneNumber: 2568815151
FaxNumber: 2568803939
Other Information
ProviderEnumerationDate: 06/08/2016
LastUpdateDate: 12/01/2020
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 12/01/2020

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207QS0010XDO2331ALY Allopathic & Osteopathic PhysiciansFamily MedicineSports Medicine
207QS0010X2019-01187NCN Allopathic & Osteopathic PhysiciansFamily MedicineSports Medicine

No ID Information.


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