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General NPI Number Information
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NPI Number | 1275723595
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Entity Type | Organization
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Legal Business Name | ANDREW W. SISK, MD, FACS
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Dates
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Enumeration Date | 08/01/2007
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Last Update Date | 01/28/2008
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Provider Practice Location Address
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Address Line | 1223 TROTWOOD AVE
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City | COLUMBIA
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State | TN
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Zip | 38401-4854
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Country | US
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Telephone | 931-381-4976
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Fax | 931-388-0600
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Provider Business Mailing Address
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Address Line | PO BOX 317
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City | COLUMBIA
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State | TN
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Zip | 38402-0317
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Country | US
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Telephone | 931-381-4976
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Fax | 931-388-0600
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Authorized Official
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Title or Position | OWNER
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Name | DR. ANDREW W. SISK
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Credential | M.D.
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Telephone | 931-381-4976
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208600000X
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Taxonomy Name | Surgery Physician
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License Number | 007326
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License Number State | TN
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