Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 208000000X | Pediatrician | 45016 | KY |
N | 208000000X | Pediatrician | ME122833 | FL |
Y | 2080P0204X | Pediatric Emergency Doctor | 45016 | KY |
NPI | 1194081133 |
---|---|
Provider Name | Dr. Adam Matthew Isacoff |
First Address | Louisville, KY 40202-3877 |
Second Address | Louisville, KY 40202-1821 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 04/04/2012 |
Last Update Date | 09/01/2021 |