Individual
DR. WILLIAM W. SISTRUNK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1900 S NATIONAL AVE, SUITE 2955, SPRINGFIELD, MO 65804-2265
(417) 820-3905
(417) 820-3528
Mailing address
PO BOX 2580, SPRINGFIELD, MO 65801-2580
(417) 829-4620
(417) 829-4316
Taxonomy
Speciality
Code
Description
License number
State
207RI0200X
Infectious Disease Physician
Primary
110134
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
208525006
—
MO
Enumeration date
12/01/2006
Last updated
07/11/2008
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