| Johnathan Milton Isom, MD, MBA | |
|
5744 Nanjack Cir, Memphis, TN 38115-2061 | |
| (901) 797-9711 | |
| (901) 797-9771 |
| Full Name | Johnathan Milton Isom |
|---|---|
| Gender | Male |
| Speciality | Anesthesiology |
| Experience | 40 Years |
| Location | 5744 Nanjack Cir, Memphis, Tennessee |
| Accepts Medicare Assignments | Yes. He accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1609832690 | NPI | - | NPPES |
| 3030932 | Other | TN | BCBS |
| 302I059810 | Other | MS | MEDICARE PTAN |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207L00000X | Anesthesiology | 20634 (Tennessee) | Primary |
| Facility Name | Location | Facility Type |
|---|---|---|
| Wellstar Kennestone Hospital | Marietta, GA | Hospital |
| Wellstar Cobb Hospital | Austell, GA | Hospital |
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|---|---|
| Wellstar Medical Group Llc | 6709065402 | 2734 |
| Entity Name | Georgia Anesthesiologists, P.c. |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1740299197 PECOS PAC ID: 7315835063 Enrollment ID: O20040305000398 |
| Entity Name | Wellstar Medical Group Llc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1558664003 PECOS PAC ID: 6709065402 Enrollment ID: O20110127000374 |
| Mailing Address | Practice Location Address |
|---|---|
| Johnathan Milton Isom, MD, MBA Po Box 400, Jackson, TN 38302-0400 Ph: (731) 425-5752 | Johnathan Milton Isom, MD, MBA 5744 Nanjack Cir, Memphis, TN 38115-2061 Ph: (901) 797-9711 |
Dr. Joel R Slade, MD Anesthesiology Medicare: Not Enrolled in Medicare Practice Location: 1910 Nonconnah Blvd, Suite 120, Memphis, TN 38132 Phone: 901-448-2300 Fax: 901-448-6657 | |
Dr. Ruth Anne Bridges, Anesthesiology Medicare: Not Enrolled in Medicare Practice Location: 6005 Park Ave, Memphis, TN 38119 Phone: 901-682-2872 | |
Dr. Jeffrey A Blalack, MD Anesthesiology Medicare: Medicare Enrolled Practice Location: 1265 Union Ave, Memphis, TN 38104 Phone: 316-685-6091 | |
Frederick D. Jones Iii, M.D. Anesthesiology Medicare: Accepting Medicare Assignments Practice Location: 5100 Poplar Ave Ste 2722, Memphis, TN 38137 Phone: 281-795-5891 | |
Dean M Harless, M.D. Anesthesiology Medicare: Not Enrolled in Medicare Practice Location: 3362 S 3rd St, Memphis, TN 38109 Phone: 901-701-2510 | |
Meghan Vogt Burkley, M.D. Anesthesiology Medicare: Medicare Enrolled Practice Location: 50 N Dunlap St, Memphis, TN 38103 Phone: 901-287-6060 | |
Simindokht Hazrati, MD Anesthesiology Medicare: Not Enrolled in Medicare Practice Location: 5744 Nanjack Cir, Memphis, TN 38115 Phone: 901-797-9711 Fax: 901-797-9771 |