# DR. ROBERT R ISACKSEN

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- **Entity:** Individual
- **Status:** Active
- **Sole proprietor:** No

## Provider details

- **NPI number:** 1972546059
- **Gender:** Man
- **Credential:** M.D.

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 208800000X | Urology Physician | 4301069750 | MI | Yes |

## Other

- **Enumeration date:** 06/14/2006
- **Last updated:** 11/27/2023

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 114331 | GREAT LAKES HLTH PLN | — |
| 05 | — | 3358181-10 | — | MI |
| 01 | — | 3403903262 | BCBS IND PIN | MI |
| 01 | — | 340C910480 | BCBS GRP PIN | MI |
| 01 | — | 5735569 | AETNA PIN | — |