Sisco, Carl William

Sisco, Carl William is an individual health care provider with primary practice located at 620 Skyline Dr , Jackson TN 38301-3923. He recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Nurse Anesthetist, Certified Registered, which is considered as his primary health care specialty. Sisco, Carl William can be contacted via phone (731) 541-7070.

Contact Information

Primary practice address
620 Skyline Dr Jackson TN 38301-3923
Phone: (731) 541-7070
Fax: (731) 541-7075
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Nurse Anesthetist, Certified Registered 367500000X 134913 Tennessee

Profile Details

NPI number 1811967961
LBN Legal business name Sisco, Carl William
Credentials Certified Registered Nurse Anesthetist (CRNA)
Entity Individual
Sole proprietor 1 No
Enumeration date Jan 23rd, 2006
Last updated Dec 7th, 2010 - about 16 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1811967961 NPPES
Tennessee MEDICAID 3630440

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