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Individual

DR. IRWIN JOHN ISAACS

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
4163 MONTGOMERY BLVD NE, ALBUQUERQUE, NM 87109-6742
(505) 554-4843
Mailing address
4163 MONTGOMERY BLVD NE, ALBUQUERQUE, NM 87109-6742
(505) 554-4843

Taxonomy

Speciality
Code
Description
License number
State
207LP2900X
Pain Medicine (Anesthesiology) Physician
Primary
2000-52
NM

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
374357
PRONET / AETNA
NM
05
515538
AZ
05
58322
NM
05
66352
NM
01
NM009R83
BLUE CROSS BLUE SHIELD
NM
Enumeration date
06/01/2005
Last updated
02/27/2017
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