Provider Demographics
NPI:1487014403
Name:ISKAROS, JONATHAN VICTOR (PA-C)
Entity type:Individual
Prefix:
First Name:JONATHAN
Middle Name:VICTOR
Last Name:ISKAROS
Suffix:
Gender:M
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:235 PEACHTREE ST NE
Mailing Address - Street 2:NORTH TOWER, SUITE 2100
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30303-1401
Mailing Address - Country:US
Mailing Address - Phone:770-994-9326
Mailing Address - Fax:770-994-4747
Practice Address - Street 1:235 PEACHTREE ST NE
Practice Address - Street 2:NORTH TOWER, SUITE 2100
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30303-1401
Practice Address - Country:US
Practice Address - Phone:770-994-9326
Practice Address - Fax:770-994-4747
Is Sole Proprietor?:No
Enumeration Date:2016-03-03
Last Update Date:2016-03-03
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
GA7876363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant