Provider Demographics
NPI:1487709580
Name:ISAACSON, ERIK (DC)
Entity type:Individual
Prefix:
First Name:ERIK
Middle Name:
Last Name:ISAACSON
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1302 1ST ST NE
Mailing Address - Street 2:
Mailing Address - City:MANDAN
Mailing Address - State:ND
Mailing Address - Zip Code:58554
Mailing Address - Country:US
Mailing Address - Phone:701-663-0480
Mailing Address - Fax:701-663-9046
Practice Address - Street 1:1302 1ST ST NE
Practice Address - Street 2:
Practice Address - City:MANDAN
Practice Address - State:ND
Practice Address - Zip Code:58554
Practice Address - Country:US
Practice Address - Phone:701-663-0480
Practice Address - Fax:701-663-9046
Is Sole Proprietor?:No
Enumeration Date:2007-01-25
Last Update Date:2007-10-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ND554111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
ND25907OtherBCBS
ND17759Medicaid
350029309OtherRAILROAD MEDICARE
ND25907OtherBCBS
ND17759Medicaid