Individual
DR. PATRICIA CISARIK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
O.D.
Contact information
Practice address
1225 MADISON AVE, MEMPHIS, TN 38104-2211
(901) 722-3250
(901) 722-3347
Mailing address
1245 MADISON AVE, MEMPHIS, TN 38104-2211
(901) 722-3250
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
0601001408
VA
152W00000X
Optometrist
2850
TN
152W00000X
Optometrist
5667T
TX
152W00000X
Optometrist
Primary
OFC27
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1512996
—
TN
01
—
2850
OD
TN
Enumeration date
05/27/2005
Last updated
03/07/2023
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