Healthcare Provider Details

I. General information

NPI: 1700886785
Provider Name (Legal Business Name): SCOTT D. ISAACS M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/30/2005
Last Update Date: 08/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

775 JOHNSON FERRY RD NE
ATLANTA GA
30342-1408
US

IV. Provider business mailing address

775 JOHNSON FERRY RD NE P.O. BOX 422448
ATLANTA GA
30342-1408
US

V. Phone/Fax

Practice location:
  • Phone: 404-531-0350
  • Fax: 404-531-4095
Mailing address:
  • Phone: 404-531-0350
  • Fax: 404-531-4095

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RE0101X
TaxonomyEndocrinology, Diabetes & Metabolism Physician
License Number39828
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: