Provider Demographics
NPI:1255315685
Name:SYBERT, DARYL R (DO)
Entity Type:Individual
Prefix:DR
First Name:DARYL
Middle Name:R
Last Name:SYBERT
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:70 S CLEVELAND AVE
Mailing Address - Street 2:
Mailing Address - City:WESTERVILLE
Mailing Address - State:OH
Mailing Address - Zip Code:43081-1397
Mailing Address - Country:US
Mailing Address - Phone:614-890-6555
Mailing Address - Fax:614-823-7075
Practice Address - Street 1:5040 FOREST DRIVE
Practice Address - Street 2:SUITE 300
Practice Address - City:NEW ALBANY
Practice Address - State:OH
Practice Address - Zip Code:43054
Practice Address - Country:US
Practice Address - Phone:614-890-6555
Practice Address - Fax:614-818-7731
Is Sole Proprietor?:No
Enumeration Date:2005-11-30
Last Update Date:2015-05-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH34004221S207XS0117X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207XS0117XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryOrthopaedic Surgery of the Spine
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0959771Medicaid
OHF78164Medicare UPIN
OHSY0755752Medicare ID - Type Unspecified
OHSY0755756Medicare PIN
OH0959771Medicaid