Individual
DR. RICHARD B SISSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
6501 LOISDALE CT FL 7, SPRINGFIELD, VA 22150-1826
(703) 922-1152
Mailing address
6501 LOISDALE CT FL 7, SPRINGFIELD, VA 22150-1826
(703) 922-1152
Taxonomy
Speciality
Code
Description
License number
State
207QS0010X
Sports Medicine (Family Medicine) Physician
Primary
0101264197
VA
390200000X
Student in an Organized Health Care Education/Training Program
DR46752
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
14226049
—
CO
01
—
21781
KAISER COMMERCIAL NUMBER
CO
Enumeration date
07/15/2008
Last updated
06/09/2021
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