Isaza, Luis Carlos
Isaza, Luis Carlos is an individual health care provider with primary practice located at 2 Professional Park Dr Ste 21 , Johnson City TN 37604-6584. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Psychiatry, Allopathic & Osteopathic Physicians / Child & Adolescent Psychiatry. Allopathic & Osteopathic Physicians / Child & Adolescent Psychiatry is his primary health care specialty. Isaza, Luis Carlos can be contacted via phone (423) 379-8120.Contact Information
Primary practice address
2 Professional Park Dr Ste 21
Johnson City TN 37604-6584
Phone: (423) 379-8120
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Psychiatry | 2084P0800X | MD-15213 | Hawaii |
| Allopathic & Osteopathic Physicians / Child & Adolescent Psychiatry | 2084P0804X | MD-15213 | Hawaii |
| Allopathic & Osteopathic Physicians / Child & Adolescent Psychiatry | 2084P0804X | 56300 | Tennessee |
Profile Details
| NPI number | 1386842672 |
|---|---|
| LBN Legal business name | Isaza, Luis Carlos |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jul 7th, 2007 |
| Last updated | Jan 18th, 2024 - about 2 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1386842672 | NPPES |
| Tennessee | MEDICAID | Q031154 |
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