Provider Demographics
NPI:1316929532
Name:ISAAC, JOSEPH A (PT, CSCS)
Entity type:Individual
Prefix:
First Name:JOSEPH
Middle Name:A
Last Name:ISAAC
Suffix:
Gender:M
Credentials:PT, CSCS
Other - Prefix:
Other - First Name:JOSEPH
Other - Middle Name:A
Other - Last Name:ISAAC
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:PT
Mailing Address - Street 1:2700 GREENUP AVENUE
Mailing Address - Street 2:
Mailing Address - City:ASHLAND
Mailing Address - State:KY
Mailing Address - Zip Code:41101-1953
Mailing Address - Country:US
Mailing Address - Phone:606-324-0540
Mailing Address - Fax:606-324-0616
Practice Address - Street 1:711 SOUTH THIRD ST
Practice Address - Street 2:
Practice Address - City:IRONTON
Practice Address - State:OH
Practice Address - Zip Code:45638-1854
Practice Address - Country:US
Practice Address - Phone:740-534-1156
Practice Address - Fax:740-534-1158
Is Sole Proprietor?:No
Enumeration Date:2005-11-15
Last Update Date:2021-09-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
225100000X
OH006817225100000X
KY002677225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2055181Medicaid
KY8700024600Medicaid
WV0005044000Medicaid
WV0005044001Medicaid
WV005044001Medicaid
KY87000246Medicaid
OH650014888OtherMEDICARE RR
OH2055182Medicaid
OH0005044001Medicaid
KY5024402Medicare PIN
OH650014888Medicare PIN
OH650014888OtherMEDICARE RR
KY8700024600Medicaid
KY650016005Medicare PIN
WV0845154Medicare PIN
WVIS0845154Medicare PIN
WV650018790Medicare PIN
WV0845153Medicare PIN