Individual
DR. KENNETH LEE SISCO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
36386 N SECRET GARDEN PATH, SAN TAN VALLEY, AZ 85140-5434
(732) 673-7050
Mailing address
36386 N SECRET GARDEN PATH, SAN TAN VALLEY, AZ 85140-5434
(732) 673-7050
Taxonomy
Speciality
Code
Description
License number
State
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
Primary
63928
AZ
Other
Enumeration date
04/03/2007
Last updated
06/15/2023
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