Isaza, Luis Carlos

Isaza, Luis Carlos is an individual health care provider with primary practice located at 2 Professional Park Dr Ste 21 , Johnson City TN 37604-6584. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Psychiatry, Allopathic & Osteopathic Physicians / Child & Adolescent Psychiatry. Allopathic & Osteopathic Physicians / Child & Adolescent Psychiatry is his primary health care specialty. Isaza, Luis Carlos can be contacted via phone (423) 379-8120.

Contact Information

Primary practice address
2 Professional Park Dr Ste 21 Johnson City TN 37604-6584
Phone: (423) 379-8120
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Psychiatry 2084P0800X MD-15213 Hawaii
Allopathic & Osteopathic Physicians / Child & Adolescent Psychiatry 2084P0804X MD-15213 Hawaii
Allopathic & Osteopathic Physicians / Child & Adolescent Psychiatry 2084P0804X 56300 Tennessee

Profile Details

NPI number 1386842672
LBN Legal business name Isaza, Luis Carlos
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jul 7th, 2007
Last updated Jan 18th, 2024 - about 10 months ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1386842672 NPPES
Tennessee MEDICAID Q031154

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