Provider Demographics
NPI:1407327265
Name:SIKES, CLARYMEL
Entity Type:Individual
Prefix:
First Name:CLARYMEL
Middle Name:
Last Name:SIKES
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 58
Mailing Address - Street 2:
Mailing Address - City:ALLEENE
Mailing Address - State:AR
Mailing Address - Zip Code:71820-0058
Mailing Address - Country:US
Mailing Address - Phone:954-682-5888
Mailing Address - Fax:
Practice Address - Street 1:321 E 13TH ST
Practice Address - Street 2:
Practice Address - City:MURFREESBORO
Practice Address - State:AR
Practice Address - Zip Code:71958-9541
Practice Address - Country:US
Practice Address - Phone:870-230-8217
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-12-05
Last Update Date:2019-04-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator