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NPI Code Detail

MEDICARE: MADISON SISK

MEDICARE: MADISON SISK
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
13747A0650XAttendant Care Provider

General Provider Information

NPI Number : 1639934920
Entity Type Code : Individual
Provider Name (Legal Business Name) : MADISON SISK
Provider Business Mailing Address
First Line : 1644 SHORES RD
Second Line :
City : GOODSPRING
State : TN
Zip : 38460-5249
Country : US
Telephone Number : 931-478-6619
Fax Number :
Provider Business Practice Location Address
First Line : 244 CHURCH ST
Second Line :
City : LYNNVILLE
State : TN
Zip : 38472-3115
Country : US
Telephone Number : 919-649-2695
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/16/2024
Last Update Date : 02/16/2024

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Directions to “ MADISON SISK ” Practice Location

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These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

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