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1124021639
CHARLES PAUL SISCO
FAYETTEVILLE, AR
NPI
1124021639
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
207RA0201X Internal Medicine, Allergy & Immunology
(Licence: AR C4144)
Enumeration Date
2005-05-31
Last Update Date
2007-07-13
Business Address
Dr. CHARLES PAUL SISCO M.D.
17994 HABBERTON RD
FAYETTEVILLE, AR 72703-9117
Phone number: 479-445-6550
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Mailing Address
Dr. CHARLES PAUL SISCO M.D.
PO BOX 65
SPRINGDALE, AR 72765-0065
Phone number: 479-445-6550
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