Provider Demographics
NPI:1700886785
Name:ISAACS, SCOTT D (MD)
Entity Type:Individual
Prefix:DR
First Name:SCOTT
Middle Name:D
Last Name:ISAACS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:775 JOHNSON FERRY RD NE
Mailing Address - Street 2:P.O. BOX 422448
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30342-1408
Mailing Address - Country:US
Mailing Address - Phone:404-531-0350
Mailing Address - Fax:404-531-4095
Practice Address - Street 1:775 JOHNSON FERRY RD NE
Practice Address - Street 2:
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30342-1408
Practice Address - Country:US
Practice Address - Phone:404-531-0350
Practice Address - Fax:404-531-4095
Is Sole Proprietor?:Yes
Enumeration Date:2005-07-30
Last Update Date:2007-08-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA39828207RE0101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RE0101XAllopathic & Osteopathic PhysiciansInternal MedicineEndocrinology, Diabetes & Metabolism
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA46BBBFJ01Medicare ID - Type Unspecified
GAG74695Medicare UPIN