Dr. Charles Paul Sisco
Internist - Allergy & Immunology
17994 Habberton Rd
Fayetteville
, Arkansas 72703-9117
Dr. Charles Paul Sisco
Internist - Allergy & Immunology
17994 Habberton Rd
Fayetteville
, Arkansas 72703-9117
(479) 445-6550
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About
Features
Specialties
- Internist - Allergy & Immunology
Languages spoken
- English
Location
First Address
- Dr. Charles Paul Sisco
- Po Box 65
- Springdale, AR
- Zip : 72765-0065
- Phone : (479) 445-6550
Second Address
- Dr. Charles Paul Sisco
- 17994 Habberton Rd
- Fayetteville, AR
- Zip : 72703-9117
- Phone : (479) 445-6550
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Scope of Practice
| Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
|---|---|---|---|---|
| Y | 207RA0201X | Internist - Allergy & Immunology | C4144 | AR |
National Provider Identifier
| NPI | 1124021639 |
|---|---|
| Provider Name | Dr. Charles Paul Sisco |
| First Address | Springdale, AR 72765-0065 |
| Second Address | Fayetteville, AR 72703-9117 |
| Gender | M |
| NPI Entity type | Individual |
| Is Sole Proprietor | Yes |
| Is Organization Subpart | N/A |
| Enumeration Date | 31/05/2005 |
| Last Update Date | 13/07/2007 |
NPI Footnotes
What is the National Provider Identifier (NPI)
Provider Location Address
Provider Mailing Address
Entity Type Code
1= Person: individual human being who furnishes health care;
2= Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)
What is a Subpart?
Provider Other Organization Name
1 = former name;
2 = professional name;
3 = doinq business as (d/b/ a) name;
4 = former legal business name;
5 = other.