Provider Demographics
NPI:1639130396
Name:ISAACMAN, SCOTT HOWARD (DO)
Entity Type:Individual
Prefix:DR
First Name:SCOTT
Middle Name:HOWARD
Last Name:ISAACMAN
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
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Mailing Address - Street 1:2500 FARM BUREAU RD
Mailing Address - Street 2:#154
Mailing Address - City:MANHATTAN
Mailing Address - State:KS
Mailing Address - Zip Code:66502-3000
Mailing Address - Country:US
Mailing Address - Phone:785-240-7643
Mailing Address - Fax:785-239-2705
Practice Address - Street 1:600 CAISSON HILL RD
Practice Address - Street 2:IRWIN ARMY HOSPITAL, IDES CLINIC
Practice Address - City:FORT RILEY
Practice Address - State:KS
Practice Address - Zip Code:66442
Practice Address - Country:US
Practice Address - Phone:785-240-7643
Practice Address - Fax:785-239-2705
Is Sole Proprietor?:No
Enumeration Date:2006-03-31
Last Update Date:2012-08-15
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
IL036064839207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine