Provider Demographics
NPI:1902213390
Name:ISAAC HEALTH & PREVENTION PARTNERS, LLC
Entity Type:Organization
Organization Name:ISAAC HEALTH & PREVENTION PARTNERS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEMBER AND MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:WILLIAM
Authorized Official - Middle Name:ALEXANDER
Authorized Official - Last Name:NIXON
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:256-505-6826
Mailing Address - Street 1:115 WALL STREET
Mailing Address - Street 2:
Mailing Address - City:ALBERTVILLE
Mailing Address - State:AL
Mailing Address - Zip Code:35951
Mailing Address - Country:US
Mailing Address - Phone:256-505-6826
Mailing Address - Fax:
Practice Address - Street 1:115 WALL STREET
Practice Address - Street 2:
Practice Address - City:ALBERTVILLE
Practice Address - State:AL
Practice Address - Zip Code:35951
Practice Address - Country:US
Practice Address - Phone:256-505-6826
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-07-17
Last Update Date:2014-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2083P0901XAllopathic & Osteopathic PhysiciansPreventive MedicinePublic Health & General Preventive MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL=========OtherEIN NUMBER