Individual
DR. EMILY A MCISAAC
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DO
Contact information
Practice address
400 W 16TH ST, PUEBLO, CO 81003-2745
(719) 584-4306
(719) 595-7886
Mailing address
400 W 16TH ST, PUEBLO, CO 81003-2745
(719) 584-4306
(719) 595-7886
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
02004078A
IN
207P00000X
Emergency Medicine Physician
Primary
DR.0053851
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
201101310
—
IN
05
—
96426039
—
CO
Enumeration date
04/05/2011
Last updated
09/25/2014
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