Individual
DR. CHARLES PAUL SISCO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
17994 HABBERTON RD, FAYETTEVILLE, AR 72703-9117
(479) 445-6550
Mailing address
PO BOX 65, SPRINGDALE, AR 72765-0065
(479) 445-6550
Taxonomy
Speciality
Code
Description
License number
State
207RA0201X
Allergy & Immunology (Internal Medicine) Physician
Primary
C4144
AR
Other
Enumeration date
05/31/2005
Last updated
07/13/2007
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