1639136211 NPI number — DR. JAMES HAJIME ISOBE M.D., FACS, RVT

Table of content: DR. JAMES HAJIME ISOBE M.D., FACS, RVT (NPI 1639136211)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1639136211 NPI number — DR. JAMES HAJIME ISOBE M.D., FACS, RVT

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
ISOBE
Provider First Name:
JAMES
Provider Middle Name:
HAJIME
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
M.D., FACS, RVT
Provider Gender Code:
M

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
ISOBE
Provider Other First Name:
JAMES
Provider Other Middle Name:
H
Provider Other Name Prefix Text:
DR.
Provider Other Name Suffix Text:
Provider Other Credential Text:
M.D., FACS, RVT
Provider Other Last Name Type Code:
2

NPI Number Information

NPI Number:
1639136211
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
02/05/2018
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
5295 PRESERVE PKWY
Provider Second Line Business Mailing Address:
STE 270
Provider Business Mailing Address City Name:
HOOVER
Provider Business Mailing Address State Name:
AL
Provider Business Mailing Address Postal Code:
35244-4705
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
205-823-0151
Provider Business Mailing Address Fax Number:
205-823-5218

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
700 MONTGOMERY HWY
Provider Second Line Business Practice Location Address:
SUITE 210
Provider Business Practice Location Address City Name:
VESTAVIA HILLS
Provider Business Practice Location Address State Name:
AL
Provider Business Practice Location Address Postal Code:
35216-1866
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
205-823-0151
Provider Business Practice Location Address Fax Number:
205-823-5218
Provider Enumeration Date:
04/27/2006

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 2086S0129X , with the licence number:  5471 , registered in the state of AL ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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