Organization
BRUCE A ISAACSON MD PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
BRUCE ISAACSON M.D. (OWNER)
(435) 755-5799
Entity
Organization
Contact information
Practice address
550 E 1400 N, SUITE Z, LOGAN, UT 84341-2406
(435) 755-5799
(435) 755-5839
Mailing address
550 E 1400 N, SUITE Z, LOGAN, UT 84341-2406
(435) 755-5799
(435) 755-5839
Taxonomy
Speciality
Code
Description
License number
State
261QP2300X
Primary Care Clinic/Center
Primary
1780691205
UT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
528845794041
—
UT
Enumeration date
07/01/2014
Last updated
07/01/2014
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