Basic Information
| Provider Information | |||||||||
| NPI: | 1902877517 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | SYBERT | ||||||||
| FirstName: | TROY | ||||||||
| MiddleName: | EUGENE | ||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | M.D., M.P.H | ||||||||
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| Mailing Information | |||||||||
| Address1: | 225 RANGEWOOD RD | ||||||||
| Address2: | |||||||||
| City: | PINEY FLATS | ||||||||
| State: | TN | ||||||||
| PostalCode: | 376864530 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4234442200 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 350 PEE DEE AVE STE A | ||||||||
| Address2: | |||||||||
| City: | ALBEMARLE | ||||||||
| State: | NC | ||||||||
| PostalCode: | 280014932 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7049861500 | ||||||||
| FaxNumber: | |||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 01/31/2006 | ||||||||
| LastUpdateDate: | 06/27/2022 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 06/27/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207R00000X | 46875 | TN | N | Allopathic & Osteopathic Physicians | Internal Medicine | 207RA0401X | 2021-03347 | NC | N | Allopathic & Osteopathic Physicians | Internal Medicine | Addiction Medicine | 2083P0901X | L7208 | TX | N | Allopathic & Osteopathic Physicians | Preventive Medicine | Public Health & General Preventive Medicine | 2083P0901X | 46875 | TN | N | Allopathic & Osteopathic Physicians | Preventive Medicine | Public Health & General Preventive Medicine | 208D00000X | 2021-03347 | NC | N | Allopathic & Osteopathic Physicians | General Practice | 207R00000X | 2021-03347 | NC | Y | Allopathic & Osteopathic Physicians | Internal Medicine |
ID Information
| ID | Type | State | Issuer | Description | 580138900 | 05 | MN | MEDICAID |