Individual
STERLING MCKISSACK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
18511 HIGHLANDER MEDICS ST, FORT BLISS, TX 79906-5327
(915) 742-9273
Mailing address
1100 WILFORD HALL LOOP BLDG 4554, JBSA LACKLAND, TX 78236-5638
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
S4347
TX
208D00000X
General Practice Physician
0101259271
VA
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
08/14/2014
Last updated
03/09/2022
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