Provider Demographics
NPI:1457576944
Name:SIKES, ALAN LEE (OD)
Entity Type:Individual
Prefix:
First Name:ALAN
Middle Name:LEE
Last Name:SIKES
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9002 FERN PARK DR
Mailing Address - Street 2:
Mailing Address - City:BURKE
Mailing Address - State:VA
Mailing Address - Zip Code:22015-1602
Mailing Address - Country:US
Mailing Address - Phone:703-978-5010
Mailing Address - Fax:703-978-5011
Practice Address - Street 1:9002 FERN PARK DR
Practice Address - Street 2:
Practice Address - City:BURKE
Practice Address - State:VA
Practice Address - Zip Code:22015-1602
Practice Address - Country:US
Practice Address - Phone:703-978-5010
Practice Address - Fax:703-978-5011
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-17
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0618000235152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist