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Individual

JAMIE DON SISK

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
203 S 12TH AVE, LAUREL, MS 39440-4324
(601) 649-9706
(601) 649-9708
Mailing address
203 S 12TH AVE, LAUREL, MS 39440-4324
(601) 649-9706
(601) 649-9708

Taxonomy

Speciality
Code
Description
License number
State
207Y00000X
Otolaryngology Physician
Primary
18509
MS

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
09301826
MS
Enumeration date
03/01/2007
Last updated
05/18/2011
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