Provider Demographics
NPI:1922602853
Name:LANDERS, ISAAC HOWARD JR
Entity Type:Individual
Prefix:MR
First Name:ISAAC
Middle Name:HOWARD
Last Name:LANDERS
Suffix:JR
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:355 BASHER DR
Mailing Address - Street 2:
Mailing Address - City:GADSDEN
Mailing Address - State:AL
Mailing Address - Zip Code:35904-6539
Mailing Address - Country:US
Mailing Address - Phone:256-390-2700
Mailing Address - Fax:
Practice Address - Street 1:2608 W MEIGHAN BLVD
Practice Address - Street 2:
Practice Address - City:GADSDEN
Practice Address - State:AL
Practice Address - Zip Code:35904-1714
Practice Address - Country:US
Practice Address - Phone:256-543-9709
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-11-22
Last Update Date:2020-11-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL9912183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist