Individual
DR. JORGE CESAR ISAAC
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D,
Contact information
Practice address
360 E 4500 S, # 4, SALT LAKE CITY, UT 84107-3992
(801) 266-0055
(801) 266-0056
Mailing address
753 JOHNNIE DODDS BLVD, MT PLEASANT, SC 29464-3054
(843) 284-3400
(843) 284-3401
Taxonomy
Speciality
Code
Description
License number
State
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
Primary
374897-1205
UT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00018771
AL MEDICAL LICENSE #
AL
01
—
374897-1205
UT MEDICAL LICENSE
UT
01
—
MD.12025R
LA MEDICAL LICENSE #
LA
01
—
ME77122
FL MEDICAL LICENSE #
FL
Enumeration date
09/14/2006
Last updated
07/08/2007
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