Individual
CHARLES CALVIN SISEMORE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
1010 N KANSAS ST, WICHITA, KS 67214-3124
(316) 293-2665
Mailing address
1010 N KANSAS ST, WICHITA, KS 67214-3124
(316) 293-2665
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
94-12340
KS
Other
Enumeration date
09/21/2023
Last updated
06/12/2025
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