Healthcare Provider Details

I. General information

NPI: 1982135273
Provider Name (Legal Business Name): DANIELLE RACHEL ISEN D.O.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: DANIELLE RACHEL SANDLER

II. Dates (important events)

Enumeration Date: 03/27/2017
Last Update Date: 11/18/2024
Certification Date: 11/18/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

601 PROVIDENCE PARK DR E
MOBILE AL
36695-4617
US

IV. Provider business mailing address

601 PROVIDENCE PARK DR E
MOBILE AL
36695-4617
US

V. Phone/Fax

Practice location:
  • Phone: 251-990-3937
  • Fax: 251-990-9990
Mailing address:
  • Phone: 251-990-3937
  • Fax: 251-990-9990

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207WX0109X
TaxonomyNeuro-ophthalmology Physician
License NumberDO.1924
License Number StateAL
# 2
Primary TaxonomyY
Taxonomy Code2084N0400X
TaxonomyNeurology Physician
License NumberDO.1924
License Number StateAL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: