Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RC0000X | Internist - Cardiovascular Disease | 32847 | WI |
N | 207RC0000X | Internist - Cardiovascular Disease | 4664 | SD |
N | 207RI0011X | Interventional Cardiology | 19546 | NV |
N | 207RI0011X | Interventional Cardiology | 32847 | WI |
N | 207RI0011X | Interventional Cardiology | 4664 | SD |
NPI | 1104884311 |
---|---|
Provider Name | Thomas C Isaacson |
First Address | Las Vegas, NV 89193-8978 |
Second Address | Las Vegas, NV 89144-6648 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 04/05/2006 |
Last Update Date | 07/09/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
0006848 | SD BCBS (01) | SD |
0529776 | (05) | IA |
103715 | UCARE (01) | |
143763100 | (05) | MN |
25-00471 | SELECTCARE (01) | |
25118 | IA BCBS (01) | IA |
35614 | HEALTH PARTNERS (01) | |
51B19IS | MN BCBS (01) | MN |
538R81IS | MN BLUE SHIELD (01) | MN |
60057719 | (05) | SD |
931451029037 | PREFERRED ONE (01) | |
F13243 | (02) | SD |