Individual
DR. JAMES A. HISSOM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
2330 W 38TH ST, ERIE, PA 16506-4564
(814) 835-8300
Mailing address
2330 W 38TH ST, ERIE, PA 16506-4564
(814) 835-8300
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
DS024068-L
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
449685
PROVIDER # FOR UNITED CON
PA
Enumeration date
01/04/2007
Last updated
07/08/2007
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