Provider Demographics
NPI:1710985932
Name:SISK, THOMAS M (MD)
Entity Type:Individual
Prefix:
First Name:THOMAS
Middle Name:M
Last Name:SISK
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6108 BROWNSVILLE ROAD EXT STE 204
Mailing Address - Street 2:
Mailing Address - City:FINLEYVILLE
Mailing Address - State:PA
Mailing Address - Zip Code:15332-4132
Mailing Address - Country:US
Mailing Address - Phone:412-719-9010
Mailing Address - Fax:724-782-0728
Practice Address - Street 1:6108 BROWNSVILLE ROAD EXT STE 204
Practice Address - Street 2:
Practice Address - City:FINLEYVILLE
Practice Address - State:PA
Practice Address - Zip Code:15332-4132
Practice Address - Country:US
Practice Address - Phone:724-782-0732
Practice Address - Fax:724-782-0728
Is Sole Proprietor?:No
Enumeration Date:2005-07-12
Last Update Date:2020-01-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DEC1-0007374207Q00000X
PAMD431688207QS0010X, 207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No207QS0010XAllopathic & Osteopathic PhysiciansFamily MedicineSports Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA113004E0DMedicare PIN