Provider Demographics
NPI:1497718258
Name:SYRIBEYS, PAUL JOHN (MD)
Entity Type:Individual
Prefix:DR
First Name:PAUL
Middle Name:JOHN
Last Name:SYRIBEYS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4030 RIVERSIDE PARK BLVD
Mailing Address - Street 2:
Mailing Address - City:MACON
Mailing Address - State:GA
Mailing Address - Zip Code:31210-1365
Mailing Address - Country:US
Mailing Address - Phone:478-474-2200
Mailing Address - Fax:478-314-0740
Practice Address - Street 1:4030 RIVERSIDE PARK BLVD
Practice Address - Street 2:
Practice Address - City:MACON
Practice Address - State:GA
Practice Address - Zip Code:31210-1365
Practice Address - Country:US
Practice Address - Phone:478-474-2200
Practice Address - Fax:478-314-0740
Is Sole Proprietor?:No
Enumeration Date:2006-04-11
Last Update Date:2008-01-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA053185208200000X, 208600000X, 2086S0122X
SC21093208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208200000XAllopathic & Osteopathic PhysiciansPlastic Surgery
No208600000XAllopathic & Osteopathic PhysiciansSurgery
No2086S0122XAllopathic & Osteopathic PhysiciansSurgeryPlastic and Reconstructive Surgery