Provider Demographics
NPI:1790820322
Name:ISAACSON NATURAL HEALTH, P.A.
Entity Type:Organization
Organization Name:ISAACSON NATURAL HEALTH, P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:SETH
Authorized Official - Middle Name:DENNIS
Authorized Official - Last Name:ISAACSON
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:480-355-1361
Mailing Address - Street 1:4856 E BASELINE RD STE 104
Mailing Address - Street 2:
Mailing Address - City:MESA
Mailing Address - State:AZ
Mailing Address - Zip Code:85206-4635
Mailing Address - Country:US
Mailing Address - Phone:480-355-1361
Mailing Address - Fax:
Practice Address - Street 1:4856 E BASELINE RD STE 104
Practice Address - Street 2:
Practice Address - City:MESA
Practice Address - State:AZ
Practice Address - Zip Code:85206-4635
Practice Address - Country:US
Practice Address - Phone:480-355-1361
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-21
Last Update Date:2012-11-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ7931111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN76D47ISOtherBLUE CROSS BLUE SHIELD
MN4206304-00Medicaid
MN647717OtherCHIROCARE OF MN
MN76D47ISOtherBLUE CROSS BLUE SHIELD
MNC04064Medicare ID - Type Unspecified