Provider Demographics
NPI:1548243074
Name:ISEAR, JEROME ABBOTT (PT)
Entity Type:Individual
Prefix:MR
First Name:JEROME
Middle Name:ABBOTT
Last Name:ISEAR
Suffix:
Gender:M
Credentials:PT
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Other - First Name:
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Mailing Address - Street 1:1717 SHIPYARD BLVD
Mailing Address - Street 2:SUITE 320
Mailing Address - City:WILMINGTON
Mailing Address - State:NC
Mailing Address - Zip Code:28403-8023
Mailing Address - Country:US
Mailing Address - Phone:910-791-0396
Mailing Address - Fax:910-791-0818
Practice Address - Street 1:1717 SHIPYARD BLVD
Practice Address - Street 2:SUITE 350
Practice Address - City:WILMINGTON
Practice Address - State:NC
Practice Address - Zip Code:28403-8023
Practice Address - Country:US
Practice Address - Phone:910-799-0110
Practice Address - Fax:910-799-1958
Is Sole Proprietor?:No
Enumeration Date:2005-11-29
Last Update Date:2009-09-03
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
NC60392251X0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251X0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistOrthopedic
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC7210565Medicaid
NC2507835AMedicare PIN