Provider Demographics
NPI:1720616915
Name:ISAAC SPINE, JOINT & PAIN INSTITUTE
Entity Type:Organization
Organization Name:ISAAC SPINE, JOINT & PAIN INSTITUTE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:VICTOR
Authorized Official - Middle Name:W
Authorized Official - Last Name:ISAAC
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:615-866-9040
Mailing Address - Street 1:3320 PERIMETER HILL DR
Mailing Address - Street 2:
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37211-4123
Mailing Address - Country:US
Mailing Address - Phone:615-866-9040
Mailing Address - Fax:615-750-5756
Practice Address - Street 1:2004 HAYES ST STE 655
Practice Address - Street 2:
Practice Address - City:NASHVILLE
Practice Address - State:TN
Practice Address - Zip Code:37203-2646
Practice Address - Country:US
Practice Address - Phone:615-866-9040
Practice Address - Fax:615-750-5756
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:ISAAC SPINE, JOINT & PAIN INSTITUTE, PLLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2020-04-01
Last Update Date:2020-06-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2081P2900XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationPain MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TNQ057658Medicaid