Provider Demographics
NPI:1396125829
Name:SYRUS, WHITNEY RAYANNE (DPM)
Entity type:Individual
Prefix:DR
First Name:WHITNEY
Middle Name:RAYANNE
Last Name:SYRUS
Suffix:
Gender:F
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:107 E WATTS ST
Mailing Address - Street 2:
Mailing Address - City:ENTERPRISE
Mailing Address - State:AL
Mailing Address - Zip Code:36330-2511
Mailing Address - Country:US
Mailing Address - Phone:334-494-8200
Mailing Address - Fax:334-460-1984
Practice Address - Street 1:141 SCOUTING CIR
Practice Address - Street 2:
Practice Address - City:TROY
Practice Address - State:AL
Practice Address - Zip Code:36081-2540
Practice Address - Country:US
Practice Address - Phone:334-494-8200
Practice Address - Fax:334-460-1984
Is Sole Proprietor?:No
Enumeration Date:2015-05-29
Last Update Date:2021-08-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL345213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle Surgery