Provider Demographics
NPI:1992236889
Name:GIVENS, SYDNEY K (PA)
Entity type:Individual
Prefix:
First Name:SYDNEY
Middle Name:K
Last Name:GIVENS
Suffix:
Gender:F
Credentials:PA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:215 HARRISON AVE
Mailing Address - Street 2:
Mailing Address - City:PANAMA CITY
Mailing Address - State:FL
Mailing Address - Zip Code:32401-2727
Mailing Address - Country:US
Mailing Address - Phone:850-233-3376
Mailing Address - Fax:
Practice Address - Street 1:106 WESTSIDE DR
Practice Address - Street 2:
Practice Address - City:DOTHAN
Practice Address - State:AL
Practice Address - Zip Code:36303-1908
Practice Address - Country:US
Practice Address - Phone:334-384-2605
Practice Address - Fax:850-522-8354
Is Sole Proprietor?:No
Enumeration Date:2017-03-23
Last Update Date:2018-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPA.9110292363A00000X
ALPA.1241363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant