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NPI Code Detail

MEDICARE: ISAAC STOUDMIRE

MEDICARE: ISAAC STOUDMIRE
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
1171M00000XCase Manager/Care Coordinator

General Provider Information

NPI Number : 1629902465
Entity Type Code : Individual
Provider Name (Legal Business Name) : ISAAC STOUDMIRE
Provider Business Mailing Address
First Line : 2000 NOBLE DR
Second Line :
City : WOOSTER
State : OH
Zip : 44691-5353
Country : US
Telephone Number : 330-439-8492
Fax Number :
Provider Business Practice Location Address
First Line : 2000 NOBLE DR
Second Line :
City : WOOSTER
State : OH
Zip : 44691-5353
Country : US
Telephone Number : 330-439-8492
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/09/2026
Last Update Date : 06/09/2026

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Directions to “ ISAAC STOUDMIRE ” Practice Location

Language Start Address Practice Location
These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

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