Doctor Name: | DR. ISAAC JOHN |
NPI Number: | 1194775692 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | MD |
License Number: | MD0000018442 |
Business Practice Address: | 5959 Park Ave Memphis, TN - 381195200 |
Business Phone Number: | 9016859640 |
Business Fax Number: | 9016859647 |
Mailing Address: | 6005 Park Ave, MEMPHIS |
State: | TN |
Postal Code: | 381195213 |
Phone Number: | 9016859640 |
Fax Number: | 9016859647 |
NPI Enumeration Date: | 05/12/2006 |
NPI Last Update Date: | 09/09/2014 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 174400000X |
License Number: | MD0000018442 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | TN |
Taxonomy Type: | Other Service Providers |
Taxonomy Classification: | Specialist |
Taxonomy Specialization: | |
Taxonomy Definition: | An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree. |