Individual
MELVIN SISCO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA
Contact information
Practice address
575 OAK RIDGE TPKE, SUITE 120, OAK RIDGE, TN 37830-7100
(865) 483-5678
(865) 483-4027
Mailing address
575 OAK RIDGE TPKE, SUITE 120, OAK RIDGE, TN 37830-7100
(865) 483-5678
(865) 483-4027
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
1103472
TN
Other
Enumeration date
04/06/2012
Last updated
04/06/2012
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