Provider Demographics
NPI:1922197045
Name:SISK, CHAD M (DO)
Entity type:Individual
Prefix:DR
First Name:CHAD
Middle Name:M
Last Name:SISK
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 11407 DEPT# 8011
Mailing Address - Street 2:
Mailing Address - City:BIRMINGHAM
Mailing Address - State:AL
Mailing Address - Zip Code:35246-8011
Mailing Address - Country:US
Mailing Address - Phone:256-571-8600
Mailing Address - Fax:256-571-8640
Practice Address - Street 1:7938 AL HIGHWAY 69 STE 310
Practice Address - Street 2:
Practice Address - City:GUNTERSVILLE
Practice Address - State:AL
Practice Address - Zip Code:35976-7135
Practice Address - Country:US
Practice Address - Phone:256-571-8600
Practice Address - Fax:256-571-8640
Is Sole Proprietor?:No
Enumeration Date:2006-10-12
Last Update Date:2025-01-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ALDO-558207RG0100X
GA059201207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology