Individual
KEVIN C SISK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
812 N 22ND ST, BLAIR, NE 68008-1128
(402) 426-4611
(402) 426-4642
Mailing address
810 N 22ND ST, BLAIR, NE 68008-1128
(402) 426-2182
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
1178
NE
207Q00000X
Family Medicine Physician
2015015493
MO
Other
Enumeration date
06/15/2012
Last updated
06/17/2020
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