Individual
DR. LUIS CARLOS ISAZA JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
2 PROFESSIONAL PARK DR STE 21, JOHNSON CITY, TN 37604-6584
(423) 379-8120
Mailing address
PO BOX 699, MOUNTAIN HOME, TN 37684-0699
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
56300
TN
2084P0800X
Psychiatry Physician
MD-15213
HI
2084P0804X
Child & Adolescent Psychiatry Physician
56300
TN
2084P0804X
Child & Adolescent Psychiatry Physician
MD-15213
HI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
Q031154
—
TN
Enumeration date
07/07/2007
Last updated
11/13/2025
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