Individual
DR. ROBERT R ISACKSEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
601 JOHN ST, SUITE M206C, KALAMAZOO, MI 49007-5341
(269) 349-9745
(269) 488-8305
Mailing address
601 JOHN ST, SUITE M206C, KALAMAZOO, MI 49007-5341
(269) 349-9745
(269) 488-8305
Taxonomy
Speciality
Code
Description
License number
State
208800000X
Urology Physician
Primary
4301069750
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
114331
GREAT LAKES HLTH PLN
—
05
—
3358181-10
—
MI
01
—
3403903262
BCBS IND PIN
MI
01
—
340C910480
BCBS GRP PIN
MI
01
—
5735569
AETNA PIN
—
Enumeration date
06/14/2006
Last updated
11/27/2023
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