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General NPI Number Information
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NPI Number | 1568333847
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Entity Type | Organization
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Legal Business Name | ISAIAH HOUSE INC
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Dates
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Enumeration Date | 09/17/2025
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Last Update Date | 10/07/2025
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Provider Practice Location Address
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Address Line | 2042 MAIN ST
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City | WILLISBURG
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State | KY
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Zip | 40078-8199
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Country | US
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Telephone | 859-375-9200
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Fax |
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Provider Business Mailing Address
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Address Line | 2044 MAIN ST
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City | WILLISBURG
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State | KY
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Zip | 40078-8199
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Country | US
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Telephone | 859-375-9200
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Fax |
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Authorized Official
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Title or Position | VP
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Name | LUCILLE KOEHL
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Credential |
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Telephone | 317-755-7433
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223D0001X
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Taxonomy Name | Public Health Dentistry
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number |
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License Number State |
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