Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RH0003X | Hematology & Oncology | 12959 | AZ |
NPI | 1033183017 |
---|---|
Provider Name | Dr. Jeffrey Dorian Isaacs |
First Address | Chandler, AZ 85246-6423 |
Second Address | Phoenix, AZ 85028-3091 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 15/02/2006 |
Last Update Date | 19/02/2013 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
229189 | (05) | AZ |