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Individual
KENNETH ISERSON
Active
Individual
KENNETH ISERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
13202
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
242107
—
AZ
01
—
9330055673
RR MEDICARE
AZ
Enumeration date
02/17/2006
Last updated
05/30/2008
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