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General NPI Number Information
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NPI Number | 1700111200
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Entity Type | Organization
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Legal Business Name | DR. MYRON ISAACS
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Dates
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Enumeration Date | 10/16/2009
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Last Update Date | 10/16/2009
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Provider Practice Location Address
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Address Line | 4434 SMUGGLERS COVE RD
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City | FREELAND
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State | WA
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Zip | 98249-9679
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Country | US
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Telephone | 360-331-4049
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Fax |
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Provider Business Mailing Address
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Address Line | 4434 SMUGGLERS COVE RD
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City | FREELAND
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State | WA
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Zip | 98249-9679
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Country | US
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Telephone | 360-331-4049
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Fax |
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Authorized Official
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Title or Position | ORTHOPEDIC SURGEON
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Name | DR. MYRON M ISAACS
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Credential | M.D.
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Telephone | 360-331-4049
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207X00000X
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Taxonomy Name | Orthopaedic Surgery Physician
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License Number | 32703
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License Number State | WA
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