DR. LUIS CARLOS ISAZA JR. (NPI# 1386842672) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1386842672 |
| Entity Type | Individual |
| Full Name | DR. LUIS CARLOS ISAZA JR. |
| Credential | MD |
| Practice Address |
Bldg 52 Lake Drive Va Medical Center Mountain Home TN 37684-0699 |
| Mailing Address |
Po Box 699 Mountain Home TN 37684-0699 |
| Practice Telephone | 4234398000 |
| Practice Fax Number | 4234392200 |
| Mailing Telephone | (423) 433-6039 |
| Mailing Fax Number | 4234336060 |
| Enumeration Date | 2007-07-07 |
| Last Update Date | 2017-08-30 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 2084P0800X |
Psychiatry & Neurology Specialization: Psychiatry |
MD-15213 | HI | Allopathic & Osteopathic Physicians |
| Y | 2084P0804X |
Psychiatry & Neurology Specialization: Child & Adolescent Psychiatry |
56300 | TN | Allopathic & Osteopathic Physicians |
| N | 2084P0804X |
Psychiatry & Neurology Specialization: Child & Adolescent Psychiatry |
MD-15213 | HI | Allopathic & Osteopathic Physicians |
| Street Address |
BLDG 52 LAKE DRIVE VA MEDICAL CENTER |
| City | MOUNTAIN HOME |
| State | TN |
| Zip Code | 37684-0699 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1740354752 | Thomas Russell Olmsted | Psychiatry & Neurology | Bldg 52 Lake Drive, Mountain Home, TN 37684 | 2006-11-20 |
| 1538699319 | Sara Taylor Mills | Nurse Practitioner | Bldg 52 Lake Drive, Va Medical Center, Mountain Home, TN 37684 | 2017-06-14 |
| 1609017961 | Michael Lee Burford | Social Worker | Bldg 52 Lake Drive, Mountain Home, TN 37684-0699 | 2009-03-17 |
| 1205960218 | Beverly Ray | Social Worker | Bldg 52 Lake Drive, Va Medical Center, Mountain Home, TN 37684-0699 | 2007-03-15 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1235730524 | Kendra Lee Thorne | Psychologist | Corner of Lamont St and Veterans Way, Building 160, Mountain Home, TN 37684 | 2020-11-04 |
| 1255930160 | Maximillian Scott Crockett | Optometrist | James. H Quillen Vamc, Eye Clinic 112e, Mountain Home, TN 37684 | 2020-10-21 |
| 1699393256 | Joshua Thomas Spencer | Pharmacist | Veterans Way and Lamont St, Mountain Home, TN 37684 | 2020-07-10 |
| 1073140265 | James Hankil Kim | Student in an Organized Health Care Education/Training Program | Building 52/lake Drive, Mountain Home, TN 37684 | 2020-03-26 |
| 1932736030 | Trishna Sharma | Student in an Organized Health Care Education/Training Program | Building 52/lake Drive Mountain Home, Johnson City, TN 37684 | 2020-03-26 |
| 1508421884 | Sarvatit Patel | Student in an Organized Health Care Education/Training Program | 52 Lake Dr, Mountain Home, TN 37684 | 2019-05-02 |
| 1902366024 | Katelyn Cserjes | Student in an Organized Health Care Education/Training Program | Building 52 Lake Drive Va Medical Center, Mountain Home, TN 37684 | 2019-03-24 |
| 1114404282 | Anesa Ellen Hughes | Pharmacist | Veterans Way and Lamont St Mountain Home, Mountain Home, TN 37684 | 2018-07-23 |
| 1508352287 | Leon Nguyen | Optometrist | James H. Quillen Vamc - Lamont St & Veterans Way, Eye Clinic 112e, Mountain Home, TN 37684 | 2018-07-06 |
| 1649761750 | Bahaaeldin Ibrahim Mahmoud Youssef | Student in an Organized Health Care Education/Training Program | Va Building 1 Carl A Jones Hall, Dogwood Avenue, Mountain Home, TN 37684 | 2018-05-24 |
| Find all providers in zip 37684 | ||||
| Taxonomy Code | 2084P0804X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Psychiatry & Neurology |
| Specialization | Child & Adolescent Psychiatry |
| Child & Adolescent Psychiatry is a subspecialty of psychiatry with additional skills and training in the diagnosis and treatment of developmental, behavioral, emotional, and mental disorders of childhood and adolescence. |
| Notes: Source: The American Board of Psychiatry and Neurology, Inc. www.abpn.com [1/1/2007: new definition] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1942561816 | Stephanie Sapna Shah | Psychiatry & Neurology | Building 52 Lake Drive, Mountain Home, TN 37684-0699 | 2012-06-06 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1457959017 | Periscope Community Health Services | Psychiatry & Neurology | 167 Belle Forest Cir, Nashville, TN 37221-2103 | 2020-10-15 |
| 1902117815 | The Family Wellness Center, LLC | Psychiatry & Neurology | 7503 Queens Ct, Suite 1, Germantown, TN 38138-3875 | 2010-06-24 |
| 1295053767 | Annie Naik Gadiparthi | Psychiatry & Neurology | 848 Adams Avenue L400, Memphis, TN 38103-8503 | 2010-05-09 |
| 1063739415 | Wellsprings Psychiatry and Counseling Center, Pllc | Psychiatry & Neurology | 109 Holiday Ct Ste D10, Franklin, TN 37067-1311 | 2010-04-26 |
| 1619154440 | 17th Avenue Psychiatry | Psychiatry & Neurology | 1503 17th Ave S, Nashville, TN 37212-2805 | 2008-01-23 |
| 1093913576 | Michael Greer Md PC | Psychiatry & Neurology | 183 Fiddlers Ln, Kingston, TN 37763-4020 | 2007-07-06 |
| 1669579116 | Jonathan David Shaw | Psychiatry & Neurology | 2911 Brunswick Road, Memphis, TN 38133 | 2006-09-19 |
| 1609971134 | Richard A Colletti | Psychiatry & Neurology | 109 Holiday Ct., D10, Franklin, TN 37067 | 2006-09-13 |
| 1407963515 | Constance L Durbin | Psychiatry & Neurology | 1135 Cully Rd, Ste 100, Cordova, TN 38016 | 2006-08-24 |
| 1558380089 | Daniel Barton | Psychiatry & Neurology | 4535 Harding Pike, Suite # 102, Nashville, TN 37205-2120 | 2006-07-18 |
| Find all providers with the same taxonomy | ||||
| City | MOUNTAIN HOME |
| Zip Code | 37684 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.