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Individual

DR. THOMAS ISENOVSKI

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
DO

Contact information

Practice address
7950 MARTIN LOOP, FORT BENNING, GA 31905-5647
(706) 544-3612
Mailing address
39 OAK ST, SARATOGA SPRINGS, NY 12866-4013
(706) 405-6779

Taxonomy

Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
055602
GA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
203563559B
GA
Enumeration date
09/26/2006
Last updated
08/13/2013
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