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General NPI Number Information
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NPI Number | 1922197045
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Entity Type | Individual
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Provider Name | CHAD M SISK D.O.
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Gender | Male
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Dates
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Enumeration Date | 10/12/2006
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Last Update Date | 01/21/2025
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Provider Practice Location Address
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Address Line | 7938 AL HIGHWAY 69 STE 310
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City | GUNTERSVILLE
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State | AL
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Zip | 35976-7135
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Country | US
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Telephone | 256-571-8600
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Fax | 256-571-8640
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Provider Business Mailing Address
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Address Line | PO BOX 11407 DEPT# 8011
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City | BIRMINGHAM
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State | AL
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Zip | 35246-8011
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Country | US
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Telephone | 256-571-8600
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Fax | 256-571-8640
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RG0100X
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Taxonomy Name | Gastroenterology Physician
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License Number | DO-558
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License Number State | AL
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Taxonomy #2
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Taxonomy Code | 207RG0100X
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Taxonomy Name | Gastroenterology Physician
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License Number | 059201
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License Number State | GA
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