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NPI Code Detail

MEDICARE: DENNIS A ISENHOWER PA-C

MEDICARE: DENNIS A ISENHOWER PA-C
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1363AM0700XMedical Physician Assistant104091NC

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1104091OTHERNCLICENSE NUMBER

General Provider Information

NPI Number : 1225026289
Entity Type Code : Individual
Provider Name (Legal Business Name) : DENNIS A ISENHOWER PA-C
Provider Business Mailing Address
First Line : 2604 MEDICAL OFFICE PL
Second Line :
City : GOLDSBORO
State : NC
Zip : 27534-9417
Country : US
Telephone Number : 919-580-0004
Fax Number : 919-580-9099
Provider Business Practice Location Address
First Line : 2604 MEDICAL OFFICE PL
Second Line :
City : GOLDSBORO
State : NC
Zip : 27534-9417
Country : US
Telephone Number : 919-580-0004
Fax Number : 919-580-9099
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/12/2005
Last Update Date : 12/26/2025

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Directions to “ DENNIS A ISENHOWER PA-C” Practice Location

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