Provider Demographics
NPI:1699207894
Name:KOH, ISAAC JOSEPH (MD, MPH)
Entity Type:Individual
Prefix:DR
First Name:ISAAC
Middle Name:JOSEPH
Last Name:KOH
Suffix:
Gender:M
Credentials:MD, MPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2145 N FAIRFIELD RD STE 100
Mailing Address - Street 2:
Mailing Address - City:BEAVERCREEK
Mailing Address - State:OH
Mailing Address - Zip Code:45431-2783
Mailing Address - Country:US
Mailing Address - Phone:937-558-3900
Mailing Address - Fax:937-558-3999
Practice Address - Street 1:2145 N FAIRFIELD RD
Practice Address - Street 2:
Practice Address - City:BEAVERCREEK
Practice Address - State:OH
Practice Address - Zip Code:45431-2580
Practice Address - Country:US
Practice Address - Phone:937-702-4031
Practice Address - Fax:937-702-4039
Is Sole Proprietor?:Yes
Enumeration Date:2017-03-28
Last Update Date:2021-01-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
OH35.140236207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program