Provider Demographics
NPI:1518247881
Name:SIBRIZZI, JACK M (DPM)
Entity Type:Individual
Prefix:DR
First Name:JACK
Middle Name:M
Last Name:SIBRIZZI
Suffix:
Gender:M
Credentials:DPM
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Mailing Address - Street 1:118 CRICKET HOLLOW RUN
Mailing Address - Street 2:
Mailing Address - City:CLAYTON
Mailing Address - State:NC
Mailing Address - Zip Code:27520-5922
Mailing Address - Country:US
Mailing Address - Phone:919-320-6333
Mailing Address - Fax:919-550-9387
Practice Address - Street 1:442 E MAIN ST STE A
Practice Address - Street 2:
Practice Address - City:CLAYTON
Practice Address - State:NC
Practice Address - Zip Code:27520-2553
Practice Address - Country:US
Practice Address - Phone:919-585-6607
Practice Address - Fax:919-585-6648
Is Sole Proprietor?:Yes
Enumeration Date:2011-08-18
Last Update Date:2018-01-04
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
NC570213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle Surgery