Provider Demographics
NPI:1336134923
Name:ISAACSON, JOHN F
Entity Type:Individual
Prefix:MR
First Name:JOHN
Middle Name:F
Last Name:ISAACSON
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:210 JPM RD
Mailing Address - Street 2:
Mailing Address - City:LEWISBURG
Mailing Address - State:PA
Mailing Address - Zip Code:17837-9367
Mailing Address - Country:US
Mailing Address - Phone:570-524-6700
Mailing Address - Fax:570-524-6710
Practice Address - Street 1:210 JPM RD
Practice Address - Street 2:
Practice Address - City:LEWISBURG
Practice Address - State:PA
Practice Address - Zip Code:17837-9367
Practice Address - Country:US
Practice Address - Phone:570-524-6700
Practice Address - Fax:570-524-6710
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-09-20
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA755276-QXXMedicare UPIN