Provider Demographics
NPI:1982771143
Name:ISAAC HEARNE MD PC
Entity Type:Organization
Organization Name:ISAAC HEARNE MD PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:ISAAC
Authorized Official - Middle Name:J
Authorized Official - Last Name:HEARNE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:775-827-8855
Mailing Address - Street 1:SUITE 22
Mailing Address - Street 2:294 E MOANA LN
Mailing Address - City:RENO
Mailing Address - State:NV
Mailing Address - Zip Code:89502-4634
Mailing Address - Country:US
Mailing Address - Phone:775-827-8855
Mailing Address - Fax:775-827-0843
Practice Address - Street 1:294 E MOANA LN
Practice Address - Street 2:SUITE 22
Practice Address - City:RENO
Practice Address - State:NV
Practice Address - Zip Code:89502-4641
Practice Address - Country:US
Practice Address - Phone:775-827-8855
Practice Address - Fax:775-827-0843
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-30
Last Update Date:2008-07-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV207W00000X, 332H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes332H00000XSuppliersEyewear Supplier
No207W00000XAllopathic & Osteopathic PhysiciansOphthalmologyGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NV5156510001Medicare NSC
NV38827Medicare PIN