Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 213E00000X | Podiatrist | 313 | TN |
N | 222Z00000X | Podiatrist | 313 | TN |
N | 224P00000X | Prosthetist | ||
N | 225000000X | Orthotic Fitter |
NPI | 1811037187 |
---|---|
Provider Name | Mr. Phillip S Isaacs |
First Address | Nashville, TN 37203 |
Second Address | Nashville, TN 37203 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 07/02/2007 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
BCBS0014308 | BLUE CROSS BLUE SHIELD (01) | TN |