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Individual

DR. ISAAC H STOVALL

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M D

Contact information

Practice address
481 INTERSTATE DR, MANCHESTER, TN 37355-3108
(931) 728-6354
(931) 728-5420
Mailing address
PO BOX 1409, MANCHESTER, TN 37349-4409
(931) 728-5420
(931) 728-5420

Taxonomy

Speciality
Code
Description
License number
State
207PE0004X
Emergency Medical Services (Emergency Medicine) Physician
Primary
MD21063
TN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
3882581
TN
Enumeration date
07/29/2006
Last updated
07/09/2007
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