Healthcare Provider Details

I. General information

NPI: 1447229729
Provider Name (Legal Business Name): KEVIN STAPLES ISEMAN PA-C
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/17/2006
Last Update Date: 07/14/2026
Certification Date: 07/14/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

78 MEDICAL CENTER DR
FISHERSVILLE VA
22939-2332
US

IV. Provider business mailing address

PO BOX 388
FISHERSVILLE VA
22939-0388
US

V. Phone/Fax

Practice location:
  • Phone: 540-332-4075
  • Fax: 540-332-5199
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number0110002787
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: