Provider Demographics
NPI:1457582850
Name:SYKES, MILTON JR
Entity Type:Individual
Prefix:MR
First Name:MILTON
Middle Name:
Last Name:SYKES
Suffix:JR
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8213 CAITLIN DR
Mailing Address - Street 2:
Mailing Address - City:OLIVE BRANCH
Mailing Address - State:MS
Mailing Address - Zip Code:38654-8073
Mailing Address - Country:US
Mailing Address - Phone:901-581-4925
Mailing Address - Fax:662-890-4499
Practice Address - Street 1:8213 CAITLIN DR
Practice Address - Street 2:
Practice Address - City:OLIVE BRANCH
Practice Address - State:MS
Practice Address - Zip Code:38654-8073
Practice Address - Country:US
Practice Address - Phone:901-581-4925
Practice Address - Fax:662-890-4499
Is Sole Proprietor?:No
Enumeration Date:2009-08-03
Last Update Date:2009-08-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MS800589962172A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes172A00000XOther Service ProvidersDriver