Provider Demographics
NPI:1053579417
Name:ISAACS, PHILLIP ALLAN (PA)
Entity type:Individual
Prefix:
First Name:PHILLIP
Middle Name:ALLAN
Last Name:ISAACS
Suffix:
Gender:M
Credentials:PA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 63362
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28263-3362
Mailing Address - Country:US
Mailing Address - Phone:919-620-4700
Mailing Address - Fax:
Practice Address - Street 1:40 DUKE MEDICINE CIR # 1L
Practice Address - Street 2:CLINIC 1L
Practice Address - City:DURHAM
Practice Address - State:NC
Practice Address - Zip Code:27710-4000
Practice Address - Country:US
Practice Address - Phone:919-681-3448
Practice Address - Fax:919-684-8955
Is Sole Proprietor?:No
Enumeration Date:2008-06-01
Last Update Date:2016-12-02
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NY005761363A00000X
NC0010-06371363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant