Individual
AMANDA ISBELL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
7219 N LITCHFIELD RD, 56 MEDICAL GROUP, GLENDALE LUKE AFB, AZ 85309-1529
(623) 856-6027
Mailing address
7219 N LITCHFIELD RD, 56 MEDICAL GROUP, GLENDALE LUKE AFB, AZ 85309-1529
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
R70191
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
R70191
TRAINING PERMIT
AZ
Enumeration date
08/27/2008
Last updated
10/07/2011
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