Individual
LANCE THAYER SISCO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
138A DUBLIN SQUARE RD, ASHEBORO, NC 27203-8627
(336) 626-2688
(336) 626-4100
Mailing address
PO BOX 5418, ASHEBORO, NC 27204-5418
(336) 625-2333
(336) 625-5511
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
33307
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
891356A
—
NC
Enumeration date
10/10/2005
Last updated
01/15/2013
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