Provider Demographics
NPI:1427849751
Name:ISA, MOHAMAD
Entity type:Individual
Prefix:MR
First Name:MOHAMAD
Middle Name:
Last Name:ISA
Suffix:
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 1:806 N PRESTON ST
Mailing Address - Street 2:
Mailing Address - City:MARKSVILLE
Mailing Address - State:LA
Mailing Address - Zip Code:71351-2118
Mailing Address - Country:US
Mailing Address - Phone:318-359-2886
Mailing Address - Fax:
Practice Address - Street 1:806 N PRESTON ST
Practice Address - Street 2:
Practice Address - City:MARKSVILLE
Practice Address - State:LA
Practice Address - Zip Code:71351-2118
Practice Address - Country:US
Practice Address - Phone:318-359-2886
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-05-15
Last Update Date:2025-05-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA343900000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)