Provider Demographics
NPI:1811037187
Name:ISAACS, PHILLIP S (BCP OST)
Entity Type:Individual
Prefix:MR
First Name:PHILLIP
Middle Name:S
Last Name:ISAACS
Suffix:
Gender:M
Credentials:BCP OST
Other - Prefix:MR
Other - First Name:STEVE
Other - Middle Name:
Other - Last Name:ISAACS
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:
Mailing Address - Street 1:121 21ST AVENUE NORTH
Mailing Address - Street 2:SUITE 207
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37203
Mailing Address - Country:US
Mailing Address - Phone:615-327-1490
Mailing Address - Fax:615-327-4898
Practice Address - Street 1:121 21ST AVENUE NORTH
Practice Address - Street 2:SUITE 207
Practice Address - City:NASHVILLE
Practice Address - State:TN
Practice Address - Zip Code:37203
Practice Address - Country:US
Practice Address - Phone:615-327-1490
Practice Address - Fax:615-327-4898
Is Sole Proprietor?:No
Enumeration Date:2007-02-07
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN313222Z00000X
224P00000X, 225000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered222Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOrthotist
Not Answered224P00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersProsthetist
Not Answered225000000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOrthotic Fitter
Provider Identifiers
StateIdentifier IDID TypeIssuer
TNBCBS0014308OtherBLUE CROSS BLUE SHIELD
TNBCBS0014308OtherBLUE CROSS BLUE SHIELD