Individual
ROGER HARLON SISK
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
3600 DALLAS HWY SW, SUITE 290, MARIETTA, GA 30064-1675
(770) 514-8986
(770) 514-0387
Mailing address
3600 DALLAS HWY SW, SUITE 290, MARIETTA, GA 30064-1675
(770) 514-8986
(770) 514-0387
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
021812
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00205213B
—
GA
Enumeration date
05/04/2006
Last updated
07/09/2007
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